This review compares the two major staging systems for renal cell carc
inoma: the TNM and Robson systems. For purposes of worldwide clinical
and scientific consistency, the TNM system is recommended. However, th
e primary tumor size cutoff of 2.5 cm. does not prognostically differe
ntiate between stages I and LI. A review of 337 patients with renal ce
ll carcinoma, of whom 122 had stage I or II disease revealed that a 2.
5-cm cutoff did not predict survival differences, while cutoffs of 5.0
, 7.5, and 10.0 cm did. Because 7.5 cm most closely approximates the m
ean renal cell cancer diameter as noted by SEER data, it is recommende
d that the TNM primary tumor cutoff be changed to 7.5 cm. (C) 1995 Wil
ey-Liss, Inc.