Pathological staging is hard to assess without nephroureterectomy. Therefore, grade is often used in clinical decision making as a surrogate for stage, with strong association.
CT chest + CT IVP is used for staging.
FDG-PET has promising fledgling data but not is not routinely used.
MRI may be useful if CT can’t be used.
Hydronephrosis likely predicts invasive disease.
| Tx | Tumour can’t be assessed |
| T0 | No evidence primary tumour |
| Ta | Non invasive papillary carcinoma |
| Tis | Carcinoma in situ |
| T1 | Invades subepithelial connective tissue |
| T2 | Invades muscularis |
| T3 | Invades beyond muscularis into peripelvic/periureteric fat or renal parenchyma |
| T4 | Invades adjacent organs, or through kidney to perinephric fat |
| Nx | Nodes can’t be assessed |
| N0 | No evidence nodal involvement |
| N1 | Single lymph node < 2 cm |
| N2 | Multiple regional nodes, or single node > 2 cm |
| Mx | Mets can’t be assessed |
| M0 | No metastatic disease |
| M1 | Distant metastases |