Renal cell carcinoma. 2002 TNM classification is still adequate?

The TNM classification should be a tool that allows the physician to make therapeutic decisions and gain even a prognostic scheme. Currently, the 2002 TNM classification for kidney cancer doesn't have these features. Really it doesn't make a distinction when performed a conservative therapy in the early stages: literature and the clinical experience suggest that the criteria for a partial resection of the kidney is the location of the tumour, rather than its size; for this reason, the division pT1 a-pT1b is rather outdated. Moreover, the T2 category, isto-pathologically restricted, receives less than 2% of all kidney cancers; into the T3 category, if there is also adrenal invasion, it makes a worse prognostic trend, similar to T4 category. The TNM classification, moreover, is inaccurate and unclear regarding the staging of lymph node involvement. For these reasons the TNM classification for parenchymal renal cell carcinoma is unreliable, so an appropriate review of the classification is needed.