Table 1.

Children’s Oncology Group Guidelines for Staging of Testicular Germ Cell Tumors

Stage	Extent of Disease
I	Limited to testis (testes), completely resected by high inguinal orchiectomy; no clinical, radiographic, or histologic evidence of disease beyond the testes. Patients with normal or unknown tumor markers at diagnosis must have a negative ipsilateral retroperitoneal node sampling to confirm Stage I disease if radiographic studies demonstrate lymph nodes > 2 cm
II	Trans-scrotal biopsy; microscopic disease in scrotum or high in spermatic cord (< 5 cm from proximal end). Failure of tumor markers to normalize or decrease with an appropriate half-life.
III	Retroperitoneal lymph node involvement, but no visceral or extra-abdominal involvement. Lymph nodes > 4 cm by CT or > 2 cm and < 4 cm with biopsy proof.
IV	Distant metastases, including liver.