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NCI: Cancer has spread (1) beyond the layer of fatty tissue around the kidney and may be found in the adrenal gland above the kidney with cancer, or in nearby lymph nodes; or (2) to other organs, such as the lungs, liver, bones, or brain, and may have spread to lymph nodes.,NCI: Stage IV includes: (T4, N0, M0); (T4, N1, M0); (Any T, N2, M0); (Any T, Any N, M1). T4: Tumor invades beyond Gerota's fascia. N0: No regional lymph node metastases. N1: Metastasis in a single regional lymph node. N2: Metastasis in more than one regional lymph node. M0: No distant metastasis. M1: Distant metastasis. (AJCC 6th ed.)
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