Scrotal mass staging TNM
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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]
Overview
According to the TNM classification and stage groupings, there are 3 stages of testicular cancer based on the size and extent of the primary tumor, number and location of any regional lymph nodes (abdominal retroperitoneal) infiltrated by tumor cells, distant metastasis, and serum tumor marker levels.[1]
Staging
The staging for testicular cancer is performed according to the TNM system with stage groupings. It can be remembered in its abbreviated form as:[2]
- 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 testicular germ cell tumors. S describes the levels of serum tumor markers in the blood after orchiectomy. The serum tumor markers measured are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH).[3]
| S | Serum tumor marker levels |
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| 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.
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| S2 | At least one tumor marker level is high. |
| S3 | At least one tumor marker level is very high.
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TNM Classification for Testicular Cancer
TNM stands for tumor, nodes, and metastasis. TNM staging describes:[2]
- 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
| TNM Classification | Definition | |
|---|---|---|
| Primary Tumor (T) | ||
| TX | Primary tumor cannot be assessed (orchiectomy not performed) | |
| T0 | No evidence of primary tumor | |
| Tis | Intratubular germ cell neoplasia (carcinoma in situ) | |
| T1 |
Tumor limited to testis and epididymis | |
| T2 |
Tumor limited to testis and epididymis | |
| T3 | Invasion of the spermatic cord | |
| T4 | Invasion of the scrotum | |
| Regional Lymph Nodes (N) | ||
| NX | Regional lymph nodes cannot be assessed | |
| N0 | No evidence of nodal involvement | |
| N1 | One or more lymph nodes involved, but all <2 cm in greatest dimension | |
| N2 | One or more lymph nodes involved 2-5 cm in greatest dimension | |
| N3 | One or more lymph nodes involved >5 cm in greatest dimension | |
| Distant Metastasis (M) | ||
| MX | Presence of metastases cannot be assessed | |
| M0 | No evidence of metastases | |
| M1 | Distant metastases present
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References
- ↑ 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
- ↑ 2.0 2.1 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
- ↑ 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