Criteria for TNM Clinical Staging: Physical examination and results of radical orchiectomy.
Criteria for TNM Pathologic Staging: Extent of disease by histologic evaluation of radical orchiectomy specimen.
Note: evaluation of specimens from a defined node bearing area (such as retroperitoneal or periaortic) must be used. In other words, there must be a lymph node dissection for Pathologic Staging.
In the 6th edition of the AJCC staging manual, an additional descriptor, S (serum tumor markers) is required for stage grouping.
Tis | Intratubular | |
pT1 |
Testis and epididymis, no vascular or lymphatic invasion | |
pT2 | Testis and epididymis with vascular or lymphatic invasion, tunica vaginalis | |
pT3 | Spermatic cord | |
pT4 | Scrotum | |
N1 | Nodal mass < 2 cm | |
N2 | Nodal mass >2 but not more than 5 cm | |
N3 | Any nodal mass > 5 cm | |
M1a | Non-regional lymph node or pulmonary metastasis | |
M1b | Distant metastasis other than to non-regional lymph nodes and lungs. | |
S1 | LDH < 1.5 times normal AND hCG < 5,000 AND AFP < 1,000 | |
S2 | LDH 1.5-10 times normal OR hCG 5,000-50,000 OR AFP 1,000-10,000 | |
S3 | LDH > 10 times normal OR hCG > 50,000 OR AFP > 10,000 |
Fore more details on Collaborative Stage, see the CS module.