Renal Cell Carcinoma Synoptic Report — CAP elements with AJCC 9th Edition (auto stage)

AJCC 9 (RCC) pT expanded summary: 
- pT1: Tumor ≤7 cm confined to kidney. Subdivided: pT1a ≤4 cm; pT1b >4–7 cm. 
- pT2: Tumor >7 cm confined to kidney. Subdivided: pT2a >7–10 cm; pT2b >10 cm. 
- pT3: Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota fascia. Subcategories: 
- pT3a: Tumor grossly extends into renal vein or its segmental branches OR invades perirenal and/or renal sinus fat but not beyond Gerota fascia. 
- pT3b: Tumor extends into IVC below diaphragm. 
- pT3c: Tumor extends into IVC above diaphragm or invades the wall of the IVC. 
- pT4: Tumor invades beyond Gerota fascia (including ipsilateral adrenal gland). 

Note: For tumors with venous thrombus, specify level (renal vein, IVC infradiaphragmatic, supradiaphragmatic) — this affects pT3b/pT3c assignment. Use pathological descriptors (gross thrombus, adherent tumor) and yp prefix for posttherapy specimens.

AJCC 9 (RCC) pN summary: 
- pN0: No regional lymph node metastasis. 
- pN1: Metastasis in regional lymph node(s). 

Regional nodal involvement upstages disease (often to stage III if confined regionally). Record number of nodes examined and positive, stations involved, and presence of extranodal extension. Distinguish between regional nodal disease and distant nodal disease.

AJCC 9 (RCC) pM summary: 
- pM0: No distant metastasis identified. 
- pM1: Distant metastasis present (pathologic confirmation when available). 

Any M1 = Stage IV. Document site(s) (lung, bone, liver, brain, distant lymph node), number of lesions when known, and method of confirmation (biopsy/surgical specimen/imaging).