Testicular cancer staging
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Testicular cancer staging On the Web |
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American Roentgen Ray Society Images of Testicular cancer staging |
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Risk calculators and risk factors for Testicular cancer staging |
Overview
Testicular cancer may be classified into several subtypes based on TNM system and the American Joint Committee on Cancer (AJCC).
Staging
The American Joint Committee on Cancer (AJCC) includes serum tumor marker levels in the stages for germ cell tumors. Doctors use S to describe the levels of serum tumor markers in the blood after surgery to remove the testicle (called orchiectomy). The serum tumor markers measured are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH).
Stage 0
| Stage | TNM and S | Definition |
|---|---|---|
| Stage 0 | Tis | Intratubular germ cell neoplasia, unclassified (IGCNU), is present |
| N0 | No regional lymph node metastasis | |
| M0 | No distant metastasis | |
| S0 | Serum tumor marker levels are normal |
Stage I
| Stage | TNM and S | Definition |
|---|---|---|
| Stage IA | T1 | The tumor is only in the testicle and epididymis;tunica albuginea |
| N0 | No regional lymph node metastasis | |
| M0 | No distant metastasis | |
| S0 | Serum tumor marker levels are normal | |
| Stage IB | T2, T3 or T4 | The tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels |
| N0 | No regional lymph node metastasis | |
| M0 | No distant metastasis | |
| S0 | Serum tumor marker levels are normal | |
| Stage IS | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N0 | No regional lymph node metastasis | |
| M0 | No distant metastasis | |
| S1, S2 or S3 | One or more serum tumor markers are higher than normal |
Stage II
| Stage | TNM and S | Definition |
|---|---|---|
| Stage IIA | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N1 | There is regional lymph node metastasis(cancer cells in 1–5 lymph nodes near the testicle; none of the lymph nodes are larger than 2 cm in diameter) | |
| M0 | No distant metastasis | |
| S0 or S1 | Serum tumour marker levels are normal or slightly high | |
| Stage IIB | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N2 | There is regional lymph node metastasis(cancer cells are in one lymph node that is 2–5 cm in diameter; cancer cells are in more than 5 lymph nodes but none of the lymph nodes are larger than 5 cm in diameter); extranodal tumour extension | |
| M0 | No distant metastasis | |
| S0 or S1 | Serum tumour marker levels are normal or slightly high | |
| Stage IIC | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N3 | There is regional lymph node metastasis(the lymph nodes with cancer are larger than 5 cm in diameter) | |
| M0 | No distant metastasis | |
| S0 or S1 | Serum tumour marker levels are normal or slightly high |
Stage III
| Stage | TNM and S | Definition |
|---|---|---|
| Stage IIIA | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| Any N | No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumour extension | |
| M1a | There is distant metastasis | |
| S0 or S1 | Serum tumour marker levels are normal or slightly high |
| Stage | TNM and S | Definition |
|---|---|---|
| Stage IIIB | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N1, N2 or N3 | There is regional lymph node metastasis; extranodal tumour extension | |
| M0 | No distant metastasis | |
| S2 | Serum tumour marker levels are high | |
| Stage IIIB | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| Any N | No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumour extension | |
| M1a | There is distant metastasis | |
| S2 | Serum tumour marker levels are high |
| Stage | TNM and S | Definition |
|---|---|---|
| Stage IIIC | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| N1, N2 or N3 | There is regional lymph node metastasis; extranodal tumour extension | |
| M0 | No distant metastasis | |
| S3 | Serum tumour marker levels are very high | |
| Stage IIIC | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| Any N | No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumour extension | |
| M1a | There is distant metastasis | |
| S3 | Serum tumour marker levels are very high | |
| Stage IIIC | Any T | The tumor is in the testicle and epididymis;the tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels;tunica albuginea;tunica vaginalis |
| Any N | No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumour extension | |
| M1b | There is distant metastasis to an organ other than the lung, such as the liver or a bone | |
| Any S | Serum tumour marker levels are normal, above normal or very high |