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Blog, Testicular Cancer

Testicular Cancer-Staging


Testicular Cancer staging helps to determine the disease prognosis and to select an appropriate treatment strategy.  TNM is the most commonly used system for staging testicular cancers by the medical community. “T” stands for “Tumor Size”, “N” for “Lymph Nodes”, “M” for “Metastasis”, and “S” stands for “Serum level of tumor markers”. Numbers and/or letters after T (is, 1, 2, 3, and 4), N (0, 1, 2, and 3), M (0, 1a, and 1b), and S (x, 0, 1, 2, and 3) provide more details about each of these factors. Once T, N, M, and S categories are determined through different diagnostic techniques, this information is combined to assign an overall stage (from 0 to IV) to the disease. Following table describes the characteristics according to different testicular cancer stages:

testicular cancer staging

 testicular cancer staging T

testicular cancer staging N and M

Stage TNM Score Description

 

0 Tis N0 M0 S0 The cancer cells are present only in the seminiferous tubules (small tube-like structures inside the testes). No spread to regional lymph nodes or distant body parts. Normal tumor marker levels.
IA T1 N0 M0 S0 Tumor limited to testis/epididymis and has invaded up to the tunica albuginea but has not grown into tunica vaginalis or nearby blood vessels/lymphatics. No spread to regional lymph nodes or distant body parts. Normal tumor marker levels.
IB T2 N0 M0 S0

 

 

 

OR

T3 N0 M0 S0

 

 

                  OR

T4 N0 M0 S0

Tumor limited to testis/epididymis and has invaded up to the tunica vaginalis or blood vessels/lymphatics involvement by the tumor. No spread to regional lymph nodes or distant body parts. Normal tumor marker levels.

OR

Tumor has invaded the spermatic cord with or without blood vessels/lymphatics involvement. No spread to regional lymph nodes or distant body parts. Normal tumor marker levels.

OR

Tumor has invaded the scrotum with or without blood vessels/lymphatics involvement. No spread to regional lymph nodes or distant body parts. Normal tumor marker levels.

IS Any T N0 M0 S1-3 An elevated level of at least one of the 3 tumor markers with a tumor limited to scrotum without spread to nearby lymph nodes or distant sites.
IIA Any T N1 M0 S0-1 Tumor spread to single or multiple regional lymph node(s) none >2 cm in greatest dimension, without spread to distant body parts. Normal tumor marker levels or elevated [LDH <1.5 × upper limit of normal, and beta-HCG <5000 mIU/ml, and AFP <1000 ng/ml].
IIB Any T N2 M0 S0-1 Tumor spread to single or multiple regional lymph node(s), any one >2 cm but </=5 cm in greatest dimension, without spread to distant body parts. Normal tumor marker levels or elevated [LDH <1.5 × upper limit of normal, and beta-HCG <5000 mIU/ml, and AFP <1000 ng/ml].
IIC Any T N3 M0 S0-1 Tumor spread to lymph node mass >5 cm in greatest dimension without spread to distant body parts Normal tumor marker levels or elevated [LDH <1.5 × upper limit of normal, and beta-HCG <5000 mIU/ml, and AFP <1000 ng/ml].
IIIA Any T Any N M1a S0-1

 

Tumor may have spread to regional lymph nodes, with spread to non-regional lymph nodes or lungs. Normal tumor marker levels or elevated [LDH <1.5 × upper limit of normal, and beta-HCG <5000 mIU/ml, and AFP <1000 ng/ml].
IIIB Any T N1-3 M0 S2

 

 

OR

Any T Any N M1a S2

Tumor spread to regional lymph nodes without distant spread. Tumor markers are elevated (LDH=1.5-10 × upper limit of normal, or beta-HCG=5000-50000 mIU/ml, or AFP=1000-10000 ng/ml).

OR

Tumor may have spread to regional lymph nodes, with spread to non-regional lymph nodes or lungs. Tumor markers are elevated (LDH=1.5-10 × upper limit of normal, or beta-HCG=5000-50000 mIU/ml, or AFP=1000-10000 ng/ml).

IIIC Any T N1-3 M0 S3

 

 

OR

Any T Any N M1a S3

 

 

 

OR

Any T Any N M1b Any S

Tumor spread to regional lymph nodes without distant spread.  Tumor markers are elevated [LDH >10 × upper limit of normal, or beta-HCG >50000 mIU/ml, or AFP >10000 ng/ml].

OR

Tumor may have spread to regional lymph nodes, with spread to non-regional lymph nodes or lungs. Tumor markers are elevated [LDH >10 × upper limit of normal, or beta-HCG >50000 mIU/ml, or AFP >10000 ng/ml].

OR

Tumor may have spread to regional lymph nodes, with spread to distant sites other than non-regional lymph nodes or lungs. Tumor markers may be normal or elevated.

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