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Stages & Grading

Stages and Grading of Advanced Kidney Cancer

It is important for patients to understand how cancer is classified into stages. AFINITOR® (everolimus) Tablets is indicated for the treatment of advanced renal cell carcinoma, or aRCC, when certain other medicines (ie, Sutent® [sunitinib] or Nexavar® [sorafenib]) have not worked.


Here is a quick overview of cancer staging and its effect on treatment.

What is cancer staging?

You will probably hear your doctor describe kidney cancer as being at a certain stage. Staging is a way of classifying cancer so that you and your health care team understand how far the cancer has progressed. Some of the tests used to determine the stage of the cancer include computerized tomography (CT) and magnetic resonance imaging (MRI) scans.


The cancer staging system tells you:

  • How large the tumor is
  • If cancer cells have spread
  • Where cancer cells have spread

What are the stages of kidney cancer?

Stage I

  • Fairly small tumor of seven centimeters or smaller that has not spread beyond the kidney

Stage II

  • Tumor larger than seven centimeters that has not spread beyond the kidney

Stage III

  • Tumor has grown a little beyond the kidney, and/or
  • Cancer cells have entered one lymph node or large blood vessel close to the kidney

Stage IV

  • Tumor has grown beyond the kidney and the tissue around it, and/or
  • Cancer cells have entered at least two lymph nodes close by or have spread to other parts of the body (this is called metastasis)

How does staging affect cancer treatment?

Once kidney cancer is diagnosed, staging helps your doctors decide on the treatment journey for you. Stages I to III can usually be treated by surgery, radiation therapy, arterial embolization, or a clinical trial of a new treatment. Treatment for stage IV kidney cancer, also called advanced kidney cancer, may start with surgery, but then usually involves treatment with one or more medicines.

What is cancer cell grading?

Grading is a system that helps doctors determine the characteristics of the cancer cells. Doctors use what is called Fuhrman grading, which grades the cancer on a scale of I through IV.


Grading is another important tool that your doctor can use to help decide what kind of treatment is appropriate for you.