Testicular cancer staging
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Shanshan Cen, M.D. [3]
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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
The diagnostic study of choice for testicular cancer is scrotal ultrasound.
Diagnostic Study of Choice
Staging
- Testicular cancer may be classified into several subtypes based on the TNM system and the American Joint Committee on Cancer (AJCC).
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).[3]
| Stage | TNM/S | Description |
|---|---|---|
| Stage 0 | pTisb | Germ cell neoplasia in situ |
| N0 | cNO No regional lymph node metastasis | |
| N0 | pN0 No regional lymph node metastasis | |
| M0 | No distant metastasis | |
| S0 | S0 Marker study levels within normal limits | |
| 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 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 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 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 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
- ↑ Benson CB (August 1988). "The role of ultrasound in diagnosis and staging of testicular cancer". Semin Urol. 6 (3): 189–202. PMID 3072643.
- ↑ Marth D, Scheidegger J, Studer UE (1990). "Ultrasonography of testicular tumors". Urol. Int. 45 (4): 237–40. doi:10.1159/000281715. PMID 2163557.
- ↑ "Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute".