CS Extension: Kidney

Note: The parenchyma of the kidney includes the following structures: cortex (outer layer of kidney) and renal columns; medulla, medullary rays, renal pyramids, and renal papillae; nephrons (renal corpuscle, loops of Henle, proximal and distal tubules, collecting duct), glomerulus, and Bowman's capsule. The most common site for renal parenchymal cancer to develop is in the proximal convoluted tubule. Tumor extension from one of these structures into another would be coded to 10 unless there were further signs of involvement.

Code	Description	TNM	SS77	SS2000
00	In situ	Tis	IS	IS
10	Invasive cancer confined to kidney cortex and/or medulla	*	L	L
20	Invasion of renal capsule Renal pelvis or calyces involved Separate focus of tumor in renal pelvis/calyx	*	L	L
30	Localized, NOS	*	L	L
39	Stated as T3, NOS	T3NOS	RE	RE
40	Adrenal (suprarenal) gland, ipsilateral Perirenal (perinephric) tissue/fat Renal (Gerota's) fascia Renal sinus fat Retroperitoneal soft tissue	T3a	RE	RE
60	Blood vessels: Extrarenal portion of renal vein or segmental branches Hilar blood vessel Inferior vena cava below diaphragm Perirenal vein Renal artery Renal vein, NOS Tumor thrombus in a renal vein, NOS	T3b	RE	RE
62	Vena cava above diaphragm or invades the wall of the vena cava	T3c	RE	RE
65	Extension beyond Gerota's fascia to: Ascending colon from right kidney Descending colon from left kidney Diaphragm Duodenum from right kidney Peritoneum Tail of pancreas Ureter, including implant(s), ipsilateral	T4	RE	RE
67	Extension beyond Gerota's fascia to: Psoas muscle	T4	D	RE
70	Ribs	T4	D	D
75	Liver Spleen Stomach	T4	D	D
80	Further contiguous extension Aorta Contralateral Adrenal (suprarenal) gland Kidney Ureter Other direct extension	T4	D	D
95	No evidence of primary tumor	T0	U	U
99	Unknown extension Primary tumor cannot be assessed Not documented in patient record	TX	U	U

* For codes 10, 20, and 30 ONLY, the T category is assigned based on the value of tumor size, as shown in the Extension Size Table for this site.