Testicular cancer staging
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
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Testicular cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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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).[1]
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. The serum tumor markers measured are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH).[2]
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 tumor 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 tumor extension | |
| M0 | No distant metastasis | |
| S0 or S1 | Serum tumor 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 tumor 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 tumor extension | |
| M1a | There is distant metastasis | |
| S0 or S1 | Serum tumor 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 tumor extension | |
| M0 | No distant metastasis | |
| S2 | Serum tumor 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 tumor extension | |
| M1a | There is distant metastasis | |
| S2 | Serum tumor 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 tumor extension | |
| M0 | No distant metastasis | |
| S3 | Serum tumor 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 tumor extension | |
| M1a | There is distant metastasis | |
| S3 | Serum tumor 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 tumor extension | |
| M1b | There is distant metastasis to an organ other than the lung, such as the liver or a bone | |
| Any S | Serum tumor marker levels are normal, above normal or very high |
References
- ↑ Testicular cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=ab Accessed on October, 13 2015
- ↑ Testicular cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=ab Accessed on October, 13 2015