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.
Brief Summaries of 6th Edition Categories
|pT1||Testis and epididymis, no vascular or lymphatic invasion|
|pT2||Testis and epididymis with vascular or lymphatic invasion, tunica vaginalis|
|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|
Collaborative Stage Elements
For more details on Collaborative Stage, see the Intro to Collaborative Staging module.