Seminoma staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

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:

• 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 III: distant metastases or moderately high serum tumor markers

The American Joint Committee on Cancer (AJCC) includes serum tumor marker levels in the stages for germ cell tumors, including seminoma. S describes the levels of serum tumour markers in the blood after orchiectomy. The serum tumor markers measured are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH).

S	Serum tumor marker levels
SX	Tumor marker levels are not available or have not been measured.
S0	Tumor marker levels are normal.
S1	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.
S2	At least one 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.
S3	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.