Which one of the following statements regarding locally advanced renal cell cancer is CORRECT?
A. T3b (TNM classification 2017) RCC have tumour thrombus in the IVC above the diaphragmAnswer B
The TNM 2017 staging classifies T3b as tumour grossly extending into the inferior vena cava below the diaphragm. The 5-year cancer-specific survival rates for T3b renal cell cancer is 40%. The ipsilateral adrenal gland should be removed when there is evidence on CT imaging of direct invasion of the adrenal gland by the renal cell cancer or a metastasis is present in the adrenal gland that appears solitary. Tumour thrombus invading the IVC wall portends a worse prognosis (T3c staging in 2017 classification) than tumour thrombus in the IVC lumen below the diaphragm (T3b staging in 2010 classification). Radical Excision of regional para-aortic lymph nodes has not been shown to significantly improve cancer specific survival.