From: Testicular Cancer Treatment (PDQ®)
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Table 2. Definition of pTNM Stages I, IA, IB, and ISa
| Stage | TNM/S | Description |
|---|---|---|
| I | pT1–4, N0, M0, SX | pT1 = Tumor limited to testis (including rete testis invasion) without lymphovascular invasion. |
| –pT1ab = Tumor <3 cm in size. | ||
| –pT1bb = Tumor ≥3 cm in size. | ||
| pT2 = Tumor limited to testis (including rete testis invasion) with lymphovascular invasion OR tumor invading hilar soft tissue or epididymis or penetrating visceral mesothelial layer covering the external surface of tunica albuginea with or without lymphovascular invasion. | ||
| pT3 = Tumor directly invades spermatic cord soft tissue with or without lymphovascular invasion. | ||
| pT4 = Tumor invades scrotum with or without lymphovascular invasion. | ||
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| SX = Marker studies not available or not performed. | ||
| IA | pT1, N0, M0, S0 | pT1 = Tumor limited to testis (including rete testis invasion) without lymphovascular invasion. |
| –pT1aa = Tumor <3 cm in size. | ||
| –pT1bb = Tumor ≥3 cm in size. | ||
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| S0 = Marker study levels within normal limits. | ||
| IB | pT2, N0, M0, S0 | pT2 = Tumor limited to testis (including rete testis invasion) with lymphovascular invasion OR tumor invading hilar soft tissue or epididymis or penetrating visceral mesothelial layer covering the external surface of tunica albuginea with or without lymphovascular invasion. |
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| S0 = Marker study levels within normal limits. | ||
| pT3, N0, M0, S0 | pT3 = Tumor directly invades spermatic cord soft tissue with or without lymphovascular invasion. | |
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| S0 = Marker study levels within normal limits. | ||
| pT4, N0, M0, S0 | pT4 = Tumor invades scrotum with or without lymphovascular invasion. | |
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| S0 = Marker study levels within normal limits. | ||
| IS | Any pT/TX, N0, M0, S1–3 | pTX = Primary tumor cannot be assessed. |
| pT0 = No evidence of primary tumor. | ||
| pTis = Germ cell neoplasia in situ. | ||
| pT1 = Tumor limited to testis (including rete testis invasion) without lymphovascular invasion. | ||
| –pT1ab = Tumor 3 cm in size. | ||
| –pT1 bb = Tumor ≥3 cm in size. | ||
| pT2 = Tumor limited to testis (including rete testis invasion) with lymphovascular invasion OR tumor invading hilar soft tissue or epididymis or penetrating visceral mesothelial layer covering the external surface of tunica albuginea with or without lymphovascular invasion. | ||
| pT3 = Tumor directly invades spermatic cord soft tissue with or without lymphovascular invasion. | ||
| pT4 = Tumor invades scrotum with or without lymphovascular invasion. | ||
| cN0 = No regional lymph node metastasis. | ||
| pN0 = No regional lymph node metastasis. | ||
| M0 = No distant metastases. | ||
| S1 = LDH < 1.5 × Nc and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000. | ||
| S2 = LDH 1.5–10 × Nc or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000. | ||
| S3 = LDH > 10 × Nc or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000. |
T = primary tumor; N = regional lymph node; M = distant metastasis; AFP = alpha fetoprotein; cN = clinical regional lymph node; hCG = human chorionic gonadotropin; LDH = lactate dehydrogenase; pT = pathological tumor; S = serum marker.
aReprinted with permission from AJCC: Testis. In: Brimo F, Srigley J, Ryan C, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp. 727–35.
bSubclassification of pT1 applies only to pure seminoma.
cN indicates the upper limit of normal for the LDH assay.