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. Author manuscript; available in PMC: 2018 May 5.
Published in final edited form as: Nat Rev Dis Primers. 2017 Mar 9;3:17009. doi: 10.1038/nrdp.2017.9

Figure 5. Stages of kidney cancer and recommended treatments.

Figure 5

Staging renal cell carcinoma (RCC) is based on size, position and lymph node involvement15. For example, a stage I or II tumour is enclosed wholly in the kidney. Stage III tumours can extend into major veins or adrenal glands within Gerota’s fascia (the layer of connective tissue encapsulating the kidneys and adrenal glands) or can involve one regional lymph node involvement. Stage IV tumours can invade beyond Gerota’s fascia and/or have distant metastases. *Until the introduction of newer targeted therapies beginning in 2005, the 5-year survival of stage IV RCC was <10%. Treatment is largely guided by stage15,24. For example, those with stage I RCC who are fit for surgery are recommended partial nephrectomy. However, radical nephrectomy is also an option; for elderly patients or those who cannot undergo surgery owing to comorbidities, active surveillance or ablative therapies are recommended. In patients with stage III RCC, radical nephrectomy is recommended with lymph node dissection in those with clinical enlarged lymph nodes, but systemic therapies might be the only available option for those with extensive disease and poor performance status.