Scenario:
- Renal US: Large left upper pole renal mass measuring up to 8.1 cm. This is considered renal cell carcinoma until proven otherwise.
- CT Ab/Pelvis:8 cm mostly exophytic upper pole left renal neoplastic lesion with internal central necrosis. Renal cell carcinoma the diagnosis of exclusion. No definite locoregional metastases of the abdomen. No left renal vein or IVC thrombus.
- Left Radical Nephrectomy-Clear cell Renal Cell Carcinoma, G3, limited to kidney, 8.5cm, unifocal, no sarcomatoid, margins negative, pT2a.
Question: How would you assign Pathologic Stage Group?
- II
- 99
Answer: 99
Rationale:
Pathologic Stage pT2a pNX cM0 Stage Group 99
You cannot assign a pathologic stage group when no lymph nodes are removed unless it is a pT3 or higher or metastatic M1 disease is present. Refer to AJCC 8th Edition Chapter 60 AJCC prognostic Stage Group Table.