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| ==Staging== | | ==Staging== |
| The staging for testicular seminoma is performed according to the '''TNM system''' with staging groupings. It can be remembered in its abbreviated form as:<ref name=testiculartumorstGING1>Testicular cancer staging. Dr Marcin Czarniecki and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-cancer-staging. Accessed on February 26, 2016</ref> | | The staging for testicular seminoma is performed according to the '''[[Seminoma staging TNM|TNM system]]''' with '''[[Seminoma staging stage grouping|staging groupings]]'''. It can be remembered in its abbreviated form as:<ref name=testiculartumorstGING1>Testicular cancer staging. Dr Marcin Czarniecki and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-cancer-staging. Accessed on February 26, 2016</ref> |
| *'''Stage I''': confined to testis, epididymis, spermatic cord, scrotum | | *'''Stage I''': confined to testis, epididymis, spermatic cord, scrotum |
| *'''Stage II''': lymph nodes involved but no distant metastases, and serum tumor markers are not very high | | *'''Stage II''': lymph nodes involved but no distant metastases, and serum tumor markers are not very high |
| *'''Stage III''': distant metastases or moderately high serum tumor markers | | *'''Stage III''': distant metastases or moderately high serum tumor markers |
|
| |
| The American Joint Committee on Cancer (AJCC) includes [[tumor marker|serum tumor marker levels]] in the stages for germ cell tumors, including seminoma. '''S''' describes the levels of serum tumor markers in the blood after [[orchiectomy]]. The serum tumor markers measured are [[AFP|alpha-fetoprotein (AFP)]], [[HCG|human chorionic gonadotropin (HCG)]], and [[LDH|lactate dehydrogenase (LDH)]].<ref name=stagingofgermcelltumors1>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 26, 2016</ref>
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|
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| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
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| |+
| |
| ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|S}}
| |
| ! style="background: #4479BA; width: 800px;" | {{fontcolor|#FFF|Serum tumor marker levels}}
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |SX
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor marker levels are not available or have not been measured.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center |S0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor marker levels are normal.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center |S1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |All tumor marker levels are above normal.
| |
| *AFP is less than 1,000 ng/mL.
| |
| *HCG is less than 5,000 mIU/mL.
| |
| *LDH is less than 1.5 times the upper limit of the normal range.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center|S2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |At least one [[tumor marker|tumor marker level]] is high.
| |
| *[[AFP]] is between 1,000 and 10,000 ng/mL.
| |
| *[[HCG]] is between 5,000 and 50,000 mIU/mL.
| |
| *[[LDH]] is 1.5–10 times the upper limit of the normal range.
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center|S3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |At least one tumor marker level is very high.
| |
| *AFP is higher than 10,000 ng/mL.
| |
| *HCG is higher than 50,000 mIU/mL.
| |
| *LDH is more than 10 times the upper limit of the normal range.
| |
| |}
| |
|
| |
| ===TNM Classification for Seminoma===
| |
| '''TNM''' stands for tumor, nodes, and metastasis. TNM staging describes:<ref name=testiculartumorstGING1>Testicular cancer staging. Dr Marcin Czarniecki and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-cancer-staging. Accessed on February 26, 2016</ref>
| |
| *size and extent of the primary tumor
| |
| *number and location of any regional lymph nodes (abdominal retroperitoneal nodes) infiltrated by tumor cells
| |
| *whether the cancer metastasized to distant part of the body
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
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| |valign=top|
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| |+
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM Classification}}
| |
| ! style="background: #4479BA; width: 600px;" | {{fontcolor|#FFF|Definition}}
| |
| |-
| |
| | style="padding: 0 5px; background: #4479BA" colspan=3 |{{fontcolor|#FFF|Primary Tumor (T)}}
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |TX
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Primary tumor cannot be assessed ([[orchiectomy]] not performed)
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center|T0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of primary tumor
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Tis
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Intratubular germ cell neoplasia (''carcinoma in situ'')
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |T1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| Tumor limited to [[testis]] and [[epididymis]]<br>
| |
| May invade [[tunica albuginea]]<br>
| |
| May NOT invade [[tunica vaginalis]]<br>
| |
| No vascular or lymphatic invasion
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |T2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |
| |
| Tumor limited to [[testis]] and [[epididymis]]<br>
| |
| Involvement of [[tunica vaginalis]]<br>
| |
| Vascular or lymphatic invasion
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |T3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Invasion of the [[spermatic cord]]
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |T4
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Invasion of the [[scrotum]]
| |
| |-
| |
| | style="padding: 0 5px; background: #4479BA" colspan=3 |{{fontcolor|#FFF|Regional Lymph Nodes (N)}}
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |NX
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Regional lymph nodes cannot be assessed
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |N0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of nodal involvement
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |N1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |One or more lymph nodes involved, but all <2 cm in greatest dimension
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |N2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |One or more lymph nodes involved 2-5 cm in greatest dimension
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |N3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |One or more lymph nodes involved >5 cm in greatest dimension
| |
| |-
| |
| | style="padding: 0 5px; background: #4479BA" colspan=3 |{{fontcolor|#FFF| Distant Metastasis (M)}}
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |MX
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Presence of metastases cannot be assessed
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of metastases
| |
| |-
| |
| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |M1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Distant [[metastasis|metastases]] present
| |
| *'''M1a''': non-regional lymph node OR pulmonary metastases
| |
| *'''M1b''': distant metastases not fulfilling M1a
| |
| |}
| |
|
| |
| ===Stage Grouping for Testicular Seminoma===
| |
| Stage grouping, is based on the '''TNM system''' and '''serum tumor marker levels (S)'''.<ref name=stagingofgermcelltumors1>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 26, 2016</ref> Each stage is given a number from 0 to 3, usually as a Roman numeral (0, I, II or III). Generally, the higher the number, the more the cancer has progressed.<ref name=stagingofgermcelltumors1>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 26, 2016</ref>
| |
|
| |
| ====Stage 0====
| |
| The following describes all stage 0 testicular cancers.<ref name=stagingofgermcelltumoiukjrsg>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 29, 2016</ref>
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|
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| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
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| |valign=top|
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| |+
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| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage 0
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|T<sub>is</sub>
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Intratubular germ cell neoplasia, unclassified (IGCNU), is present.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no regional lymph node metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[tumor marker|Serum tumor marker]] levels are normal.
| |
| |}
| |
|
| |
| ====Stage I====
| |
| Stage I testicular cancer can be one of the following.<ref name=stagingofgermcelltumoiukjrsg>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 29, 2016</ref>
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
| |
| |+
| |
| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IA
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|T1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is only in the [[testicle]] and [[epididymis]]. It hasn’t grown into lymph or blood vessels. The tumor may have grown into the [[tunica albuginea]].
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no regional lymph node metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[tumor marker|Serum tumor marker]] levels are normal.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IB
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|T2,<br>T3,<br>T4
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It has grown into lymph or blood vessels or the tumor is in the [[tunica vaginalis]].The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no regional lymph node metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[tumor marker|Serum tumor marker]] levels are normal.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IS
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no regional lymph node metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S1,<br>S2,<br>S3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |One or more [[tumor marker|serum tumor markers]] are higher than normal.
| |
| |}
| |
|
| |
| ====Stage II====
| |
| Stage II testicular cancer can be one of the following.<ref name=stagingofgermcelltumoiukjrsg>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 29, 2016</ref>
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
| |
| |+
| |
| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIA
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is regional lymph node metastasis. There are cancer cells in 1–5 lymph nodes near the testicle. None of the lymph nodes are larger than 2 cm in diameter.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0,<br>S1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are normal or slightly high.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIB
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is regional lymph node metastasis. Cancer cells are in one lymph node that is 2–5 cm in diameter or in more than 5 lymph nodes but none of the lymph nodes are larger than 5 cm in diameter. The cancer may have spread outside of the lymph nodes to surrounding tissues (''extranodal tumor extension'').
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0,<br>S1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are normal or slightly high.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIC
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is regional lymph node metastasis. There are cancer cells in at least one lymph node. The lymph nodes with cancer are larger than 5 cm in diameter.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0,<br>S1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are normal or slightly high.
| |
| |}
| |
|
| |
| ====Stage III====
| |
| Stage III testicular cancer can be one of the following.<ref name=stagingofgermcelltumoiukjrsg>Staging testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=on. Accessed on February 29, 2016</ref>
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
| |
| |+
| |
| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIA
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There may or may not be regional lymph node metastasis. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M1a
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis, i.e. the cancer has spread to lymph nodes farther from the testicle or to the lungs.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S0,<br>S1
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are normal or slightly high.
| |
| |}
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
| |
| |+
| |
| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIB
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N1,<br>N2,<br>or<br>N3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is regional lymph node [[metastasis]]. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are high.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIB
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There may or may not be regional lymph node metastasis. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M1a
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis, i.e. the cancer has spread to lymph nodes farther from the testicle or to the lungs.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S2
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are high.
| |
| |}
| |
|
| |
| {| style="border: 0px; font-size: 90%; margin: 3px; width:1000px"
| |
| |valign=top|
| |
| |+
| |
| ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}}
| |
| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|TNM and S}}
| |
| ! style="background: #4479BA; width: 750px;" | {{fontcolor|#FFF|Explanation}}
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIC
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|N1,<br>N2,<br>or<br>N3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is regional lymph node [[metastasis]]. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M0
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is no distant metastasis.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are very high.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIC
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There may or may not be regional lymph node metastasis. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M1a
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis, i.e. the cancer has spread to lymph nodes farther from the testicle or to the lungs.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |S3
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are very high.
| |
| |-
| |
| | rowspan=4 style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |Stage IIIC
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any T
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is in the [[testicle]] and [[epididymis]]. It may have grown into lymph or blood vessels. Or the tumor has grown into the [[tunica albuginea]] or both [[tunica albuginea] and [[tunica vaginalis]]. The tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center|any N
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There may or may not be regional lymph node metastasis. The tumor may have extranodal tumor extension.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |M1b
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis to an organ other than the lung, such as the liver or a bone.
| |
| |-
| |
| | style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align=center |any S
| |
| | style="padding: 5px 5px; background: #F5F5F5;" |Serum tumour marker levels are normal, high, or very high.
| |
| |}
| |
|
| |
|
| ==References== | | ==References== |