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Staging

Staging is a process that determines how widespread the cancer may be. The stage tells the doctor if the cancer has spread and if so, how far it has spread. Staging systems change over time. The staging system below is the current staging system used by the Children's Oncology Group.

• Stage I: Tumor was inside the kidney and completely removed by the surgeon. The outside covering (capsule) of the kidney is intact at removal meaning that the tumor did not break open nor did the surgeon open the capsule for a biopsy before removal of the tumor from the body. Some treatment protocols require the surgeon to take out lymph nodes so they can be examined under the microscope for tumors cells.
• Stage II: Tumor grew beyond the kidney and was completely removed by the surgeon.
• Stage III: Tumor could not be completely removed and there is still tumor present in the abdomen. This could be due because:
  • Tumor cells are found in lymph nodes in the abdomen
  • Tumor cells spread into or onto the membranes of the intestines
  • Tumor cells are seen under the microscope at the edge of the surgery specimen
  • Tumor was left behind because of spread into an important structure
  • Tumor cells spilled into the abdomen before or after surgery
  • The tumor was biopsied
  • Tumor is removed in more than one piece
• Stage IV: Tumor has spread outside of the local region to the lung, liver, bone or brain. This would also include spread to lymph nodes outside of the abdomen. Spread to the adrenal gland only is not considered stage IV.
• Stage V: Tumor in both kidneys

Of those with clear cell sarcoma of the kidney, 25 % of the children have stage I disease, 18% stage II, 41% stage III, 29% stage IV, and none have stage V.

The most common sites for the clear cell sarcoma of the kidney to spread in patients with stage IV disease are the lymph nodes (most frequent), the bones, the lungs, the abdomen, the brain, and the liver (least frequent).