Table 2a.
Staging of testis tumours: UICC/American Joint Committee on Cancer
| TNM staging | Unit | Value |
|---|---|---|
| Primary tumour* | pTX | Primary tumour cannot be assessed. (If no radical orchidectomy has been performed, Tx is used) |
| pT0 | No evidence of primary tumour (e.g., histologic scar in testis) | |
| pTis | Intratubular germ cell neoplasia (carcinoma in situ) | |
| pT1 | Tumour limited to the testis and epididymis without vascular/lymphatic invasion. Tumour may invade into the tunica albuginea but not the tunica vaginalis. | |
| pT2 | Tumour limited to the testis and epididymis with vascular/lymphatic invasion, or tumour extending through the tunica albuginea with involvement of the tunica vaginalis | |
| pT3 | Tumour invades the spermatic cord with or without vascular/lymphatic invasion | |
| pT4 | Tumour invades the scrotum with or without vascular/lymphatic invasion | |
| Regional lymph nodes (N) clinical | NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastasis | |
| N1 | Metastasis with a lymph node mass 2 cm or less in greatest dimension; or multiple lymph nodes, none more than 2 cm in greatest dimension | |
| N2 | Metastasis with a lymph node mass, more than 2 cm but not more than 5 cm in greatest dimension; or multiple lymph nodes, any one mass greater than 2 cm but not more than 5 cm in greatest dimension | |
| N3 | Metastasis with a lymph node mass more than 5 cm in greatest dimension | |
| M1 | Distant metastasis | |
| M1a | Non-regional nodal or pulmonary metastasis | |
| M1b | Non-pulmonary visceral metastasis | |
| Serum tumour markers (S) | SX | Marker studies not available or not performed |
| S0 | Marker study levels within normal limits | |
| S1 | LDH <1.5 × Normal and HCG (mIu/mL) < 5000 and AFP (ug/mL) < 1000 | |
| S2 | LDH 1.5 – 10 × Normal or HCG (mIu/mL) 5000 – 50 000 or AFP (ug/mL) 1000 – 10 000 | |
| S3 | LDH >10 × Normal or HCG (mIu/mL) > 50 000 or AFP (ug/mL) > 10 000 | |
|
Stage grouping | ||||
|---|---|---|---|---|
| Stage | Tumour | Node | Metastasis | Serum factor |
| Stage 0 | pTis | N0 | M0 | S0 |
| Stage I | pT1–4 | N0 | M0 | SX |
| Stage IA | pT1 | N0 | M0 | S0 |
| Stage 1B | pT2 | N0 | M0 | S0 |
| pT3 | N0 | M0 | S0 | |
| pT4 | N0 | M0 | S0 | |
| Stage IS | Any T | N0 | M0 | S1–3 |
| Stage II | Any T | N1–3 | M0 | SX |
| Stage IIA | Any T | N1 | M0 | S0 |
| Any T | N1 | M0 | S1 | |
| Stage IIB | Any T | N2 | M0 | S0 |
| Any T | N2 | M0 | S1 | |
| Stage IIC | Any T | N3 | M0 | S0 |
| Any T | N3 | M0 | S1 | |
| Stage III | Any T | Any N | M1 | SX |
| Stage IIIA | Any T | Any N | M1a | S0 |
| Any T | Any N | M1a | S1 | |
| Stage IIIB | Any T | N1-3 | M0 | S2 |
| Any T | Any N | M1a | S2 | |
| Stage IIIC | Any T | N1-3 | M0 | S3 |
| Any T | Any N | M1a | S3 | |
| Any T | Any N | M1B | Any S | |
*
The extent of primary tumour is classified after radical orchidectomy.
LDH = lactate dehydrogenase; HCG = human chorionic gonadotrophin; AFP = alpha-fetoprotein. Adapted from Sobin LH, Wittekind C (eds). UICC TNM classification of malignant tumours. 6th ed. New York: John Wiley & Sons, 2002.