Staging and grading of upper urinary tract urothelial cancer (UTUC)
What is staging and grading?
Your cancer doctor needs certain information about the upper urinary tract urothelial cancer (UTUC) to advise you on the best treatment for you. This includes the following:
- the stage of the cancer – this describes its size and whether it has spread
- the grade of the cancer – this gives an idea of how quickly the cancer might grow and spread.
This information comes from the tests you have had.
Your cancer doctor and specialist nurse will talk to you about this. They will explain how it helps you and your doctor decide on your treatment plan.
Staging of upper urinary tract urothelial cancer (UTUC)
Staging refers to:
- how far the cancer has grown into the tissues of the ureter or renal pelvis
- whether it has spread to lymph nodes or other parts of the body.
Stages may be described as a number from 0 to 4.
Stage 0
This stage is also called carcinoma in situ. The cancer is only growing on the inside of the lining (mucosa) of the renal pelvis or ureter. It is not growing through it.
Stage 1
The cancer has spread through the inner lining (mucosa) of the renal pelvis or ureter, into the connective tissue.
Stage 2
The cancer has grown into the muscle layer of the renal pelvis or ureter.
Stage 3
- For cancer of the renal pelvis – the cancer has grown through the muscle to the tissue or fat inside the kidney.
- For cancer of the ureter – the cancer has grown through the muscle into the fat that surrounds the ureter.
Stage 4
The cancer has spread to one or more of the following areas:
- the layerdy, such as the lung, liver, or bone.
Other terms used for cancer stages
Your doctor may use the following terms to describe the stage of the cancer:
Localised
The cancer is only in the area where it started and has not spread outside the kidney or ureter.
Regional
The cancer has spread to the tissue around the kidney or to nearby lymph nodes.
Metastatic (secondary)
The cancer has spread to other parts of the body.
See also:
Grading of upper urinary tract urothelial cancer (UTUC)
Grading is how the cancer cells look under a microscope compared with normal cells.
Upper urinary tract urothelial cancer (UTUC) is given a grade from 1 to 3.
- Low grade means the cancer cells are more like normal cells. Grade 1 and some grade 2 cancer cells are slow growing and less likely to spread.
- High grade means the cancer cells are less like normal cells. Grade 3 cancer cells grow more quickly and are more likely to spread.
Grading covers a range, so sometimes grade 2 cancers are described as high grade.
About our information
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ReferencesBelow is a sample of the sources used in our upper urinary tract urothelial cancer (UTUC) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
European Association of Urology. Upper urinary tract urothelial carcinoma guidelines. EAU Guidelines. Edn. presented at the EAU Annual Congress Copenhagen 2018. ISBN 978-94-92671-01-1. Available from www.uroweb.org/wp-content/uploads/Upper-Urinary-Tract-Urothelial-Carcinoma-large-text-V3.pdf (accessed April 2021).
National Institute for Health and Care Excellence (NICE). Atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable. Technology appraisal guidance (TA492). Published 06 December 2017. Last updated 12 July 2018. Available from www.nice.org.uk/guidance/TA492 (accessed April 2021)
Birtle A, et al. Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial. The Lancet, 2020; 395, 10232, 1268-1277. Available from www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30415-3/fulltext (accessed June 2021).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Lisa Pickering, Consultant Medical Oncologist.
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