Testicular cancer staging: Difference between revisions

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Latest revision as of 10:19, 28 May 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Shanshan Cen, M.D. [3]

Overview

The diagnostic study of choice for testicular cancer is scrotal ultrasound.

Diagnostic Study of Choice

The diagnostic study of choice for testicular cancer is scrotal ultrasound.^[1]^[2]^[3]

Staging

Testicular cancer may be classified into several subtypes based on the TNM system and the American Joint Committee on Cancer (AJCC).

The American Joint Committee on Cancer (AJCC) includes serum tumor marker levels in the stages for germ cell tumors. Doctors use S to describe the levels of serum tumor markers in the blood after surgery to remove the testicle. The serum tumor markers measured are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH).^[4]



Stage	TNM/S	Description
Stage 0	pTis^b	Germ cell neoplasia in situ
	N0	cNO No regional lymph node metastasis
	N0	pNO No regional lymph node metastasis
	M0	No distant metastasis
	SO	SO Marker study levels within normal limits
Stage I	pT1	Tumor limited to testis (including rete testis invasion) without lymphovascular invasion.
	pT1a^b	Tumor <3 cm in size
	pT1b^b	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.
	cNO	No regional lymph node metastasis.
	pNO	No regional lymph node metastasis.
	MO	No distant metastasis.
	SX	Marker studies not available or not performed.
Stage IA	pT1	Tumor limited to testis (including rete testis invasion) without lymphovascular invasion.
	pT1a^a	Tumor <3 cm in size
	pT1b^b	Tumor ≥3 cm in size
	cNO	No regional lymph node metastasis.
	pNO	No regional lymph node metastasis.
	MO	No distant metastasis.
	S0	Marker study levels within normal limits.
Stage IB	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 metastasis
	S0	Marker study levels within normal limits.
	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 metastasis
	S0	Marker study levels within normal limits.
	pT4	Tumor invades scrotum with or without lymphovascular invasion.
	cN0	No regional lymph node metastasis
	pN0	No regional lymph node metastasis
	M0	No distant metastasis
	S0	Marker study levels within normal limits.
Stage IS	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.
	pT1a^b	Tumor 3 cm in size.
	pT1b^b	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 metastasis
	S1	LDH < 1.5 × N^c and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
	S2	LDH 1.5–10 × N^c or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
	S3	LDH > 10 × N^c or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
Stage II	Any pT/TX	Primary tumor cannot be assessed/Marker studies not available or not performed.
	cN1	Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pN1	Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M0	No distant metastases.
	SX	Marker studies not available or not performed.
Stage IIA	Any pT/TX	Primary tumor cannot be assessed/Marker studies not available or not performed.
	cN1	Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
	pN1	Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
	M0	No distant metastasis
	S1	LDH < 1.5 × N^b and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
Stage IIB	Any pT/TX	See above description.
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	M0	No distant metastases.
	S0	Marker study levels within normal limits.
	pT/TX	See above description
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	M0	No distant metastases.
	S1	LDH < 1.5 × N^b and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
Stage IIC	Any pT/TX	See above description.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M0	No distant metastases.
	S0	Marker study levels within normal limits.
	Any pT/TX	See above description.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M0	No distant metastasis
	S1	LDH < 1.5 × N^b and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
Stage III	Any pT/TX	See above description.
	cNX	Regional lymph nodes cannot be assessed.
	cN0	No regional lymph node metastasis.
	cN1	Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pNX	Regional lymph nodes cannot be assessed.
	pN0	No regional lymph node metastasis.
	pN1	Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M1	Distant metastases.
	M1a	Nonretroperitoneal nodal or pulmonary metastases.
	M1b	Nonpulmonary visceral metastases.
	SX	Marker studies not available or not performed.
Stage IIIA	Any pT/TX	See above description.
	Any N	See descriptions in this table, Stage III.
	M1a	Nonretroperitoneal nodal or pulmonary metastases.
	S0	Marker study levels within normal limits.
	Any pT/TX	See above description.
	Any N	See descriptions in this table, Stage III.
	M1a	Nonretroperitoneal nodal or pulmonary metastases.
	S1	LDH < 1.5 × N^b and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
Stage IIIB	Any pT/TX	See above descriptions
	cN1	Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pN1	Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M0	No distant metastases.
	S2	LDH 1.5–10 × N^b or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
	Any pT/TX	See above descriptions
	Any N	See descriptions in this table, Stage III.
	M1a	Nonretroperitoneal nodal or pulmonary metastases.
	S2	LDH 1.5–10 × N^b or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
Stage IIIC	Any pT/TX	See above descriptions.
	cN1	Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
	cN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
	cN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	pN1	Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
	pN2	Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
	pN3	Metastasis with a lymph node mass >5 cm in greatest dimension.
	M0	No distant metastases.
	S3	LDH > 10 × N^b or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
	Any pT/TX	See above descriptions.
	Any N	See descriptions in this table, Stage III.
	M1a	Nonretroperitoneal nodal or pulmonary metastases.
	S3	LDH > 10 × N^b or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
	Any pT/TX	See above descriptions.
	Any N	See descriptions in this table, Stage III.
	M1b	Nonpulmonary visceral metastases.
	SX	Marker studies not available or not performed.
	S0	Marker study levels within normal limits.
	S1	LDH < 1.5 × N^b and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
	S2	DH 1.5–10 × N^b or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
	S3	LDH > 10 × N^b or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.

References

↑ Benson CB (August 1988). "The role of ultrasound in diagnosis and staging of testicular cancer". Semin Urol. 6 (3): 189–202. PMID 3072643.
↑ Marth D, Scheidegger J, Studer UE (1990). "Ultrasonography of testicular tumors". Urol. Int. 45 (4): 237–40. doi:10.1159/000281715. PMID 2163557.
↑ Boccellino M, Vanacore D, Zappavigna S, Cavaliere C, Rossetti S, D'Aniello C, Chieffi P, Amler E, Buonerba C, Di Lorenzo G, Di Franco R, Izzo A, Piscitelli R, Iovane G, Muto P, Botti G, Perdonà S, Caraglia M, Facchini G (November 2017). "Testicular cancer from diagnosis to epigenetic factors". Oncotarget. 8 (61): 104654–104663. doi:10.18632/oncotarget.20992. PMC 5732834. PMID 29262668.
↑ "Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute".

Template:WikiDoc Sources

[pmid3072643-1] Benson CB (August 1988). "The role of ultrasound in diagnosis and staging of testicular cancer". Semin Urol. 6 (3): 189–202. PMID 3072643.

[pmid2163557-2] Marth D, Scheidegger J, Studer UE (1990). "Ultrasonography of testicular tumors". Urol. Int. 45 (4): 237–40. doi:10.1159/000281715. PMID 2163557.

[pmid29262668-3] Boccellino M, Vanacore D, Zappavigna S, Cavaliere C, Rossetti S, D'Aniello C, Chieffi P, Amler E, Buonerba C, Di Lorenzo G, Di Franco R, Izzo A, Piscitelli R, Iovane G, Muto P, Botti G, Perdonà S, Caraglia M, Facchini G (November 2017). "Testicular cancer from diagnosis to epigenetic factors". Oncotarget. 8 (61): 104654–104663. doi:10.18632/oncotarget.20992. PMC 5732834. PMID 29262668.

[urlTesticular_Cancer_Treatment_(PDQ®)—Health_Professional_Version_-_National_Cancer_Institute-4] "Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute".

[1]

[2]

[3]

[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{CMG}}; {{AE}} {{G.D.}}, {{SC}}
 {{Testicular cancer}}
 ==Overview==
-The diagnostic study of choice for testicular cancer is scrotal ultrasound.
+The [[diagnostic]] study of choice for testicular cancer is scrotal [[ultrasound]].
 ==Diagnostic Study of Choice==
-*The diagnostic study of choice for testicular cancer is scrotal ultrasound.<ref name="pmid3072643">{{cite journal |vauthors=Benson CB |title=The role of ultrasound in diagnosis and staging of testicular cancer |journal=Semin Urol |volume=6 |issue=3 |pages=189–202 |date=August 1988 |pmid=3072643 |doi= |url=}}</ref><ref name="pmid2163557">{{cite journal |vauthors=Marth D, Scheidegger J, Studer UE |title=Ultrasonography of testicular tumors |journal=Urol. Int. |volume=45 |issue=4 |pages=237–40 |date=1990 |pmid=2163557 |doi=10.1159/000281715 |url=}}</ref>
+*The [[diagnostic]] study of choice for testicular cancer is scrotal [[ultrasound]].<ref name="pmid3072643">{{cite journal |vauthors=Benson CB |title=The role of ultrasound in diagnosis and staging of testicular cancer |journal=Semin Urol |volume=6 |issue=3 |pages=189–202 |date=August 1988 |pmid=3072643 |doi= |url=}}</ref><ref name="pmid2163557">{{cite journal |vauthors=Marth D, Scheidegger J, Studer UE |title=Ultrasonography of testicular tumors |journal=Urol. Int. |volume=45 |issue=4 |pages=237–40 |date=1990 |pmid=2163557 |doi=10.1159/000281715 |url=}}</ref><ref name="pmid29262668">{{cite journal |vauthors=Boccellino M, Vanacore D, Zappavigna S, Cavaliere C, Rossetti S, D'Aniello C, Chieffi P, Amler E, Buonerba C, Di Lorenzo G, Di Franco R, Izzo A, Piscitelli R, Iovane G, Muto P, Botti G, Perdonà S, Caraglia M, Facchini G |title=Testicular cancer from diagnosis to epigenetic factors |journal=Oncotarget |volume=8 |issue=61 |pages=104654–104663 |date=November 2017 |pmid=29262668 |pmc=5732834 |doi=10.18632/oncotarget.20992 |url=}}</ref>
 ==Staging==
 *Testicular cancer may be classified into several subtypes based on the [[TNM system]] and the [[American Joint Committee on Cancer]] (AJCC).
-The [[American Joint Committee on Cancer]] (AJCC) includes serum [[tumor marker]] levels in the stages for [[germ cell tumors]]. Doctors use '''S''' to describe the levels of serum tumor markers in the blood after surgery to remove the [[testicle]]. The serum tumor markers measured are [[alpha-fetoprotein]] (AFP), [[human chorionic gonadotropin]] (HCG), and [[lactate dehydrogenase]] (LDH).<ref name="urlTesticular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/testicular/hp/testicular-treatment-pdq#_721 |title=Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
+The [[American Joint Committee on Cancer]] (AJCC) includes [[serum]] [[tumor marker]] levels in the stages for [[germ cell tumors]]. Doctors use '''S''' to describe the levels of [[Tumor markers|serum tumor markers]] in the [[blood]] after [[surgery]] to remove the [[testicle]]. The [[serum]] [[tumor markers]] measured are [[alpha-fetoprotein]] (AFP), [[human chorionic gonadotropin]] (HCG), and [[lactate dehydrogenase]] (LDH).<ref name="urlTesticular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/testicular/hp/testicular-treatment-pdq#_721 |title=Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"
-|valign=top|
+! valign="top" |
 |+
 ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF| Stage}}
@@ Line 19: / Line 20: @@
 ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF| Description}}
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=5|Stage 0
+! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" |Stage 0
 | style="padding: 5px 5px; background: #F5F5F5;" |pTis<sup>b</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Germ cell neoplasia in situ
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Germ cells|Germ cell]] [[neoplasia]] [[in situ]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |N0
-| style="padding: 5px 5px; background: #F5F5F5;" |cNO No regional lymph node [[metastasis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |cNO No [[Lymph node|regional lymph node]] [[metastasis]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |N0
-| style="padding: 5px 5px; background: #F5F5F5;" |pNO No regional lymph node [[metastasis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |pNO No [[Lymph nodes|regional lymph node]] [[metastasis]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |M0
@@ Line 33: / Line 34: @@
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |SO
-| style="padding: 5px 5px; background: #F5F5F5;" |SO Marker study levels within normal limits
+| style="padding: 5px 5px; background: #F5F5F5;" |SO [[Marker]] study levels within normal limits
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=10|Stage I
+! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" |Stage I
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor limited to testis (including rete testis invasion) without lymphovascular invasion.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] limited to [[testis]] (including [[Rete testis|rete testis invasion]]) without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1a<sup>b</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor <3 cm in size
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] <3 cm in size
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1b<sup>b</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor ≥3 cm in size
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] ≥3 cm in size
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT2
-| style="padding: 5px 5px; background: #F5F5F5;" |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.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] limited to [[testis]] (including [[Rete testis|rete testis invasion]]) with lymphovascular invasion OR [[tumor]] invading hilar soft tissue or [[epididymis]] or penetrating [[visceral]] [[Mesothelial|mesothelia]]<nowiki/>l layer covering the external surface of [[Tunica albuginea (testicles)|tunica albuginea]] with or without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT3
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor directly invades spermatic cord soft tissue with or without lymphovascular invasion.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] directly invades [[spermatic cord]] [[soft tissue]] with or without [[Vascular|lymphovascular]] invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT4
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor invades scrotum with or without lymphovascular invasion.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] invades [[scrotum]] with or without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |cNO
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[Lymph nodes|lymph node]] [[metastasis]].
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pNO
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] [[metastasis]].
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |MO
@@ Line 64: / Line 65: @@
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |SX
-| style="padding: 5px 5px; background: #F5F5F5;" |Marker studies not available or not performed.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Marker|Marker studies]] not available or not performed.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=7|Stage IA
+! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" |Stage IA
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor limited to testis (including rete testis invasion) without lymphovascular invasion.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] limited to [[testis]] (including [[Rete testis|rete testis invasion]]) without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1a<sup>a</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor <3 cm in size
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] <3 cm in size
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1b<sup>b</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor ≥3 cm in size
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] ≥3 cm in size
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |cNO
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] [[metastasis]].
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pNO
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[Lymph nodes|lymph node]] [[metastasis]].
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |MO
@@ Line 88: / Line 89: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=15|Stage IB
+! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" |Stage IB
 | style="padding: 5px 5px; background: #F5F5F5;" |pT2
-| style="padding: 5px 5px; background: #F5F5F5;" |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.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] limited to testis (including [[Rete testis|rete testis invasion]]) with lymphovascular invasion OR tumor invading [[Hilar|hila]]<nowiki/>r soft tissue or [[epididymis]] or penetrating visceral mesothelial layer covering the external surface of tunica albuginea with or without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |cN0
@@ Line 134: / Line 135: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=15|Stage IS
+! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" |Stage IS
 | style="padding: 5px 5px; background: #F5F5F5;" |pTX
-| style="padding: 5px 5px; background: #F5F5F5;" |Primary tumor cannot be assessed.
+| style="padding: 5px 5px; background: #F5F5F5;" |Primary [[tumor]] cannot be assessed.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT0
@@ Line 142: / Line 143: @@
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pTis
-| style="padding: 5px 5px; background: #F5F5F5;" |Germ cell neoplasia in situ.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Germ cell]] [[neoplasia]] [[in situ]].
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor limited to testis (including rete testis invasion) without lymphovascular invasion.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] limited to testis (including rete testis invasion) without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1a<sup>b</sup>
-| style="padding: 5px 5px; background: #F5F5F5;" |Tumor 3 cm in size.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] 3 cm in size.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT1b<sup>b</sup>
@@ Line 154: / Line 155: @@
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT2
-| style="padding: 5px 5px; background: #F5F5F5;" |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.
+| style="padding: 5px 5px; background: #F5F5F5;" |[[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 (penis)|tunica albuginea]] with or without lymphovascular invasion.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |pT3
@@ Line 180: / Line 181: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |LDH > 10 × N<sup>c</sup> or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=9|Stage II
+! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" |Stage II
 | style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
 | style="padding: 5px 5px; background: #F5F5F5;" |Primary tumor cannot be assessed/Marker studies not available or not performed.
@@ Line 208: / Line 209: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |Marker studies not available or not performed.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=5|Stage IIA
+! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIA
 | style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
 | style="padding: 5px 5px; background: #F5F5F5;" |Primary tumor cannot be assessed/Marker studies not available or not performed.
@@ Line 224: / Line 225: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |LDH < 1.5 × N<sup>b</sup> and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=10|Stage IIB
+! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIB
 | style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
 | style="padding: 5px 5px; background: #F5F5F5;" |See above description.
@@ Line 255: / Line 256: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |LDH < 1.5 × N<sup>b</sup> and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=10|Stage IIC
+! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIC
 | style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
 | style="padding: 5px 5px; background: #F5F5F5;" |See above description.
@@ Line 286: / Line 287: @@
 | style="padding: 5px 5px; background: #F5F5F5;" |LDH < 1.5 × N<sup>b</sup> and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIIB
+! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" |Stage III
-| style="padding: 5px 5px; background: #F5F5F5;" |Any T
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
-| style="padding: 5px 5px; background: #F5F5F5;" |The [[tumor]] is in the testicle and [[epididymis]]; the tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or [[blood vessels]]; [[tunica albuginea]]; [[tunica vaginalis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |See above description.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cNX
+| style="padding: 5px 5px; background: #F5F5F5;" |Regional lymph nodes cannot be assessed.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN0
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN1
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN3
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pNX
+| style="padding: 5px 5px; background: #F5F5F5;" |Regional lymph nodes cannot be assessed.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN0
+| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN1
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN3
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M1
+| style="padding: 5px 5px; background: #F5F5F5;" |Distant metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M1a
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonretroperitoneal nodal or pulmonary metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M1b
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonpulmonary visceral metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |SX
+| style="padding: 5px 5px; background: #F5F5F5;" |Marker studies not available or not performed.
+|-
+! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIIA
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
+| style="padding: 5px 5px; background: #F5F5F5;" |See above description.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |Any N
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] metastasis; there is regional [[lymph node]] metastasis; extranodal tumor extension
+| style="padding: 5px 5px; background: #F5F5F5;" |See descriptions in this table, Stage III.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |M1a
-| style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonretroperitoneal nodal or pulmonary metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S0
+| style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
+| style="padding: 5px 5px; background: #F5F5F5;" |See above description.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |Any N
+| style="padding: 5px 5px; background: #F5F5F5;" |See descriptions in this table, Stage III.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M1a
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonretroperitoneal nodal or pulmonary metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S1
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH < 1.5 × N<sup>b</sup> and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
+|-
+! rowspan="13" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIIB
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
+| style="padding: 5px 5px; background: #F5F5F5;" |See above descriptions
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN1
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN3
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN1
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN3
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M0
+| style="padding: 5px 5px; background: #F5F5F5;" |No distant metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S2
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH 1.5–10 × N<sup>b</sup> or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
+| style="padding: 5px 5px; background: #F5F5F5;" |See above descriptions
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |Any N
+| style="padding: 5px 5px; background: #F5F5F5;" |See descriptions in this table, Stage III.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |M1a
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonretroperitoneal nodal or pulmonary metastases.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |S2
-| style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are high
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH 1.5–10 × N<sup>b</sup> or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
+|-
+! rowspan="21" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIIC
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
+| style="padding: 5px 5px; background: #F5F5F5;" |See above descriptions.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN1
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastases with a lymph node mass ≤2 cm in greatest dimension OR multiple lymph nodes, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |cN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension OR multiple lymph nodes, any one mass >2 cm but ≤5 cm in greatest dimension.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIIC
+| style="padding: 5px 5px; background: #F5F5F5;" |cN3
-| style="padding: 5px 5px; background: #F5F5F5;" |Any T
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
-| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is in the testicle and [[epididymis]]; the tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels; [[tunica albuginea]]; [[tunica vaginalis]]
 |-
-| style="padding: 5px 5px; background: #F5F5F5;" |N1, N2 or N3
+| style="padding: 5px 5px; background: #F5F5F5;" |pN1
-| style="padding: 5px 5px; background: #F5F5F5;" |There is regional [[lymph node]] metastasis; extranodal tumor extension
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass ≤2 cm in greatest dimension and ≤5 nodes positive, none >2 cm in greatest dimension.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN2
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >2 cm but ≤5 cm in greatest dimension; or >5 nodes positive, none >5 cm; or evidence of extranodal extension of tumor.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |pN3
+| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis with a lymph node mass >5 cm in greatest dimension.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |M0
-| style="padding: 5px 5px; background: #F5F5F5;" |No distant [[metastasis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |No distant metastases.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |S3
-| style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are very high
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH > 10 × N<sup>b</sup> or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIIC
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
-| style="padding: 5px 5px; background: #F5F5F5;" |Any T
+| style="padding: 5px 5px; background: #F5F5F5;" |See above descriptions.
-| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is in the testicle and [[epididymis]]; the tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or blood vessels; [[tunica albuginea]]; [[tunica vaginalis]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |Any N
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] metastasis; there is regional [[lymph node]] metastasis; extranodal tumor extension
+| style="padding: 5px 5px; background: #F5F5F5;" |See descriptions in this table, Stage III.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |M1a
-| style="padding: 5px 5px; background: #F5F5F5;" |There is distant [[metastasis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonretroperitoneal nodal or pulmonary metastases.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |S3
-| style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are very high
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH > 10 × N<sup>b</sup> or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIIC
+| style="padding: 5px 5px; background: #F5F5F5;" |Any pT/TX
-| style="padding: 5px 5px; background: #F5F5F5;" |Any T
+| style="padding: 5px 5px; background: #F5F5F5;" |See above descriptions.
-| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is in the testicle and [[epididymis]]; the tumor may have spread to the [[spermatic cord]] or [[scrotum]], and may have grown into lymph or [[blood vessels]]; [[tunica albuginea]]; [[tunica vaginalis]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |Any N
-| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] metastasis; there is regional [[lymph node]] metastasis; extranodal tumor extension
+| style="padding: 5px 5px; background: #F5F5F5;" |See descriptions in this table, Stage III.
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" |M1b
-| style="padding: 5px 5px; background: #F5F5F5;" |There is distant metastasis to an organ other than the [[lung]], such as the [[liver]] or a [[bone]]
+| style="padding: 5px 5px; background: #F5F5F5;" |Nonpulmonary visceral metastases.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |SX
+| style="padding: 5px 5px; background: #F5F5F5;" |Marker studies not available or not performed.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S0
+| style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S1
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH < 1.5 × N<sup>b</sup> and hCG (mIU/mL) <5,000 and AFP (ng/mL) <1,000.
 |-
-| style="padding: 5px 5px; background: #F5F5F5;" |Any S
+| style="padding: 5px 5px; background: #F5F5F5;" |S2
-| style="padding: 5px 5px; background: #F5F5F5;" |Serum [[tumor marker]] levels are normal, above normal or very high
+| style="padding: 5px 5px; background: #F5F5F5;" |DH 1.5–10 × N<sup>b</sup> or hCG (mIU/mL) 5,000–50,000 or AFP (ng/mL) 1,000–10,000.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" |S3
+| style="padding: 5px 5px; background: #F5F5F5;" |LDH > 10 × N<sup>b</sup> or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000.
 |}

Testicular cancer staging: Difference between revisions

Latest revision as of 10:19, 28 May 2019

Overview

Diagnostic Study of Choice

Staging

References

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