RENAL PELVIS AND URETER (ICD‐O‐3 C65, C66)

Rules for Classification

The classification applies to carcinomas. Papilloma is excluded. There should be histological or cytological confirmation of the disease.

Anatomical Sites (Fig. 506)

Renal pelvis (C65)
Ureter (C66)

Regional Lymph Nodes (Fig. 507)

The regional lymph nodes are the hilar, abdominal para‐aortic, and paracaval nodes and, for ureter, intrapelvic nodes. Laterality does not affect the N classification.

TNM Clinical Classification

T – Primary Tumour

TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
Ta	Noninvasive papillary carcinoma (Fig. 516)
Tis	Carcinoma in situ
T1	Tumour invades subepithelial connective tissue (Fig. 516)
T2	Tumour invades muscularis (Fig. 516)
T3	(Renal pelvis) Tumour invades beyond muscularis into peripelvic fat or renal parenchyma (Fig. 517)
	(Ureter) Tumour invades beyond muscularis into periureteric fat (Fig. 517)
T4	Tumour invades adjacent organs (Figs. 518, 519) or through the kidney into perinephric fat (Fig. 520)

Schematic illustration of Noninvasive papillary carcinoma,Tumour invades subepithelial connective tissue, Tumour invades muscularis. — **Fig. 516**

Schematic illustration of (Renal pelvis) Tumour invades beyond muscularis into peripelvic fat or renal parenchyma, (Ureter) Tumour invades beyond muscularis into periureteric fat. — **Fig. 517**

Schematic illustration of tumour invades adjacent organs. — **Fig. 518**

Schematic illustration of tumour invades through the kidney into
perinephric fat. — **Fig. 520**

N – Regional Lymph Nodes

NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single lymph node 2 cm or less in greatest dimension (Fig. 521)
N2	Metastasis in a single lymph node more than 2 cm or multiple lymph nodes (Figs. 522, 523)