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Renal Cell Cancer Prognosis

Renal cell cancer is the most common type of kidney cancer. Approximately nine out of 10 kidney cancers are renal cell cancers. Generally, renal cell cancer involves the growth of a single tumor within one kidney, although tumors occasionally can be found in both kidneys and/or multiple tumors may be found in one kidney. Generally, renal cell cancers are asymptomatic until they are quite advanced, but routine CT scans or ultrasounds often reveal them before they metastasize and become untreatable.

  1. Types of Renal Cell Cancers

    • There are several different types of renal cell cancers, which are diagnosed based on the appearance of the cells under a microscope. The majority of those diagnosed with renal cell cancer have clear cell renal carcinoma, in which the cancer cells appear clear when viewed under a microscope. Papillary renal cell carcinoma is the second most common type of renal cell cancer, diagnosed in approximately 10 percent to 15 percent of patients. These cancers appear as little fingerlike projections. Papillary renal cell cancers are also called chromophilic, because when the cells are injected with dye for viewing under a microscope, the cells appear pink. Chromophobe renal cell cancers are the next most common type, accounting for 5 percent of renal cell cancers. These cells appear pale, like those in clear cell cancer, but are much larger than those in traditional clear cell cancer. The rarest type of renal cell cancer is collecting duct renal cell carcinoma, in which the cancer cells appear in irregular tubes. Finally, if the cells do not fit into any of the above categories, they are referred to as unclassified renal cell carcinoma.

    Staging

    • The prognosis of renal cell cancer depends on the stage of the cancer. Like all kidney cancers, your doctor will determine the stage using the AJCC system pioneered by the American Joint Committee on Cancer. The AJCC system is also referred to as the TNM system, for the three factors used to evaluate the stage of the cancer. The "T" factor addresses the size of the tumor. The "N" factor deals with lymph node involvement. The "M" factor assesses whether the cancer has metastasized, or spread, to other parts of your body.

    Stage I

    • Stage I kidney cancer comprises a T number of 1, and an N and M number of 0. This means that there is no lymph node involvement or metastasis. The tumor itself is smaller than 7 cm long, and is in only your kidney. The five-year survival rate for those diagnosed with Stage I renal cell cancer is 96 percent.

    Stage II

    • Stage II renal cell cancer comprises a T number of 2, and an N and M number of 0. This means the tumor has extended beyond 7 cm in length, but still has not spread outside your kidney. There is no lymph node involvement or metastasis. The five-year survival rate is 82 percent.

    Stage III

    • Stage III renal cell cancer has several different characteristics, however in general, the five-year survival rate for all patients diagnosed with Stage III renal cell cancer is 64 percent. The first type of Stage III renal cell cancer includes a T number of 3, with an N and M number of 0. This means there is still no lymph node involvement or metastasis, but the tumor has grown beyond just your kidney into the adrenal gland, the renal vein, the vena cava or the fatty tissue surrounding the kidney. The second type of stage III renal cancer includes a T number between 1 and 3, so the tumor is any size, as long as it has not spread beyond Gerota's fascia. However, in this stage, the cancer has spread to one lymph node that is near your kidney.

    Stage IV

    • Stage IV renal cell cancer also has several different options. The first is a T number of 4, with an N number of 0 or 1, and an M number of 0. This means the primary tumor has extended beyond the Gerota's fascia, it is in no more than one lymph node, and it has not metastasized to any distinct organs. Stage IV renal cell cancer also refers to cancers with any T number, an M number of 0, and an N number of 2. This means there is no metastasis, the tumor can be any size, and there is involvement of more than one lymph node local to your kidney. Finally, Stage IV may include any T and N number, with an M number of 1. This means the cancer has spread to lymph nodes not local to the kidney, and/or other organs in the body distinct from your kidney. In all cases, the five-year survival rate for stage IV renal cancer is 23 percent.

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