(... tran-ZIH-shuh-nul sel KAN-ser ... REE-nul PEL-vus ... YER-eh-ter) 
Cancer has spread to at least one of the following: (1) a nearby organ; (2) the layer of fat around the kidney; (3) lymph nodes; and/or (4) other parts of the body, such as the lung, liver, or bone.