J Clin Pathol 65:367-371 doi:10.1136/jclinpath-2011-200468
  • Original article

Accuracy of the revised 2010 TNM classification in predicting the prognosis of patients treated for renal cell cancer in the north east of England

  1. R Heer1,3
  1. 1Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
  2. 2Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  3. 3Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Mr Rakesh Heer, Northern Institute for Cancer Research, Paul O'Gorman Building, Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; rakesh.heer{at}
  1. Contributors RV: data collection, manuscript drafting. RS: data collection. AE-S, MIJ: manuscript review. NS, RH: study design, manuscript review.

  • Accepted 10 December 2011
  • Published Online First 28 January 2012


Background The TNM classification for renal cell cancer (RCC) should accurately predict and assign prognostic information for patients. In this study the recent 2010 revision to the TNM classification was compared with the previous 2002 classification with regard to survival outcomes.

Methods All patients having radical nephrectomy for RCC in the 5-year period 2004–8 at a tertiary referral centre were included. Pathological and radiological records were reviewed to identify TNM stage (2002 and 2010 classification) and survival data were captured.

Results 345 patients with RCC were identified. Based on the 2002 TNM staging system and using outcomes in T1 staged tumours as a baseline, statistically significant differences in disease-specific survival were noted between patients with T1 and T3b tumours (log rank p<0.001) but not between those with T1 and T3a tumours (p=0.33). However, when tumour stage was reassigned according to the 2010 classification, patients with T3a tumours were also found to do statistically worse than T1 staged disease (p<0.001).

Conclusion In our cohort, the new 2010 TNM reclassification of T3 tumours showed better correlation with predicting worsening outcomes compared with localised disease.


  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.