Pathologic Staging

CAP Approved Pediatric • Wilms Tumor 3.1.0.2

Children’s Oncology Group Staging System for pediatric renal tumors other than renal cell carcinoma (select all that apply under the appropriate stage)

___ Stage I:  Tumor limited to kidney and completely resected

___        Penetration of renal capsule by tumor not identified

___        Tumor involvement of extrarenal or renal sinus lymph-vascular spaces

not identified

___        Tumor metastasis to lymph nodes not identified

___ Stage II:  Tumor extends beyond kidney but completely resected

___        Tumor extends through the renal capsule but with negative resection

margin

___        Tumor involvement of extrarenal or renal sinus lymph-vascular spaces

present

___        Tumor involves renal vein but has not been transected and is not

attached to vein wall at resection margin

___        Tumor extensively involves the renal sinus soft tissue

___ Stage III:  Residual tumor

___        Tumor present at margin(s) of resection

___        Tumor capsular rupture identified

___        Tumor spill before or during surgery identified

___        Piecemeal excision of tumor (removal of tumor in more than 1 piece)

___        Metastatic tumor in regional lymph nodes identified

___        History of renal tumor biopsy before definitive surgery

___ Stage IV:  Metastatic disease

___        Hematogenous metastases or lymph node metastases outside the

abdomino-pelvic region (beyond renal drainage system, eg, lung, liver)

___ Stage V

___ Bilateral renal involvement at diagnosis (each side should also be staged

separately, according to above criteria, as I to IV)

Specify (both):  Right kidney stage: ___

   Left kidney stage: ___

Pediatric

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