Skip to content
My WebMD Sign In, Sign Up

Cancer Health Center

Font Size

Testicular Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Testicular Cancer

Table 3. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Testis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 469-78.
M0No distant metastasis.
M1Distant metastasis.
M1aNonregional nodal or pulmonary metastasis.
M1bDistant metastasis other than to nonregional lymph nodes and lung.

Table 4. Anatomic Stage/Prognostic Groupsa

GroupTNMS (Serum Tumor Markers)
a Reprinted with permission from AJCC: Testis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 469-78.
0pTisN0M0S0
IpT1–4N0M0SX
IApT1N0M0S0
IBpT2N0M0S0
pT3N0M0S0
pT4N0M0S0
ISAny pT/TxN0M0S1–3
IIAny pT/TxN1–3M0SX
IIAAny pT/TxN1M0S0
Any pT/TxN1M0S1
IIBAny pT/TxN2M0S0
Any pT/TxN2M0S1
IICAny pT/TxN3M0S0
Any pT/TxN3M0S1
IIIAny pT/TxAny NM1SX
IIIAAny pT/TxAny NM1aS0
Any pT/TxAny NM1aS1
IIIBAny pT/TxN1–3M0S2
Any pT/TxAny NM1aS2
IIICAny pT/TxN1–3M0S3
Any pT/TxAny NM1aS3
Any pT/TxAny NM1bAny S

Table 5. Site-Specific Prognostic Factorsa

Serum Tumor Markers (S) Required for Staging
a Reprinted with permission from AJCC: Testis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 469-78.
b AFP = alpha-fetoprotein; hCG = human chorionic gonadotropin; LDH = lactase dehydrogenase; N indicates the upper limit of normal for the LDH assay.
SXMarker studies not available or not performed.
S0Marker study levels within normal limits.
S1LDH <1.5 × Nband hCG (mIu/ml) <5,000and AFP (ng/ml) <1,000.
S2LDH 1.5–10 × Nor hCG (mIu/ml) 5,000–50,000or AFP (ng/ml) 1,000–10,000.
S3LDH >10 × Nor hCG (mIu/ml) >50,000or AFP (ng/ml) >10,000.

In addition to the clinical stage definitions, surgical stage may be designated based on the results of surgical removal and microscopic examination of tissue.

Stage I

Stage I testicular cancer is limited to the testis. Invasion of the scrotal wall by tumor or interruption of the scrotal wall by previous surgery does not change the stage but does increase the risk of spread to the inguinal lymph nodes, and this must be considered in treatment and follow-up. Invasion of the epididymis tunica albuginea and/or the rete testis does not change the stage. Invasion of the tunica vaginalis or lymphovascular invasion signifies a T2 tumor, while invasion of the spermatic cord signifies a T3 tumor, and invasion of the scrotum signifies a T4. Increases in T stage are associated with increased risk of occult metastatic disease and recurrence. Men with stage I disease who have persistently elevated serum tumor markers after orchiectomy are staged as IS, but stage IS nonseminomas are treated as stage III. Elevated serum tumor markers in stage I or II seminoma are of unclear significance except that a persistently elevated or rising hCG usually indicates metastatic disease.

1|2|3

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

Colorectal cancer cells
A common one in both men and women.
Lung cancer xray
See it in pictures, plus read the facts.
 
sauteed cherry tomatoes
Fight cancer one plate at a time.
Ovarian cancer illustration
Do you know the symptoms?
 
Jennifer Goodman Linn self-portrait
Blog
what is your cancer risk
HEALTH CHECK
 
colorectal cancer treatment advances
Video
breast cancer overview slideshow
SLIDESHOW
 
prostate cancer overview
SLIDESHOW
lung cancer overview slideshow
SLIDESHOW
 
ovarian cancer overview slideshow
SLIDESHOW
Actor Michael Douglas
Article