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  • Staging, grading and prognosis of kidney cancer



    The stage of a cancer describes how large it is, where it is, and whether it has spread in the body. Knowing the stage of the kidney cancer helps doctors plan the best treatment for you. The stage can be given before surgery (clinical staging), but may be revised after surgery (pathologic staging).

    If you have kidney cancer, your doctor will use the results of the tests to assign a stage:

    • stages I–II are considered early kidney cancer
    • stages III–IV are considered advanced kidney cancer.


    By examining a tissue sample taken during a biopsy or surgery, doctors can see how similar the cancer cells look to normal cells and estimate how fast the cancer would grow without any treatment. This is called grading. It helps them decide what follow-up treatment you might need and whether to consider a clinical trial.

    There are different systems for grading kidney cancer. The Fuhrman system has been widely used in Australia, but a newer system called the International Society of Urological Pathology (ISUP) system has been introduced. Both systems grade kidney cancer from 1 to 4, with grade 1 being the slowest growing and grade 4 the fastest growing.


    Prognosis means the expected outcome of a disease. It is not possible for anyone to predict the exact course of the disease, but your medical team can give you an idea about common issues that affect people with kidney cancer.

    The stage of the cancer is the main factor in determining prognosis. In most cases, the earlier that kidney cancer is diagnosed, the better the chance of successful treatment. If the cancer is found after it has spread to other parts of the body, it is very unlikely that all of the cancer can be removed, but treatment can often keep it under control.

    People who can have surgery to remove the cancer tend to have better outcomes. However, other factors such as your age, general fitness and medical history also affect prognosis.

    Which health professionals will I see?

    Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist such as a urologist. The specialist will arrange further tests. If kidney cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you will see a range of health professionals who specialise in different aspects of your care.

    This website page was last reviewed and updated November 2019

    Information reviewed by: A/Prof Declan Murphy, Urologist and Director of Genitourinary Oncology, Peter MacCallum Cancer Centre, VIC; Dr Carole Harris, Medical Oncologist, St George and Sutherland Hospitals, and Clinical Lecturer, The University of New South Wales, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; A/Prof Shankar Siva, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Beth Stone, Consumer

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