Testicular cancer staging: Difference between revisions

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==Overview==
==Overview==
The diagnostic study of choice for testicular cancer is scrotal ultrasound.
The diagnostic study of choice for testicular cancer is scrotal ultrasound.
Testicular cancer may be classified into several subtypes based on the [[TNM system]] and the [[American Joint Committee on Cancer]] (AJCC).
==Diagnostic Study of Choice==
==Diagnostic Study of Choice==
*The diagnostic study of choice for testicular cancer is scrotal ultrasound.
*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>


==Staging==
==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>Testicular cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=ab Accessed on October, 13 2015 </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 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>Testicular cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=ab Accessed on October, 13 2015 </ref>



Revision as of 16:37, 6 March 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]

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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]

Staging

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).[3]

Stage 0

Stage TNM and S Definition
Stage 0 Tis Intratubular germ cell neoplasia, unclassified (IGCNU), is present
N0 No regional lymph node metastasis
M0 No distant metastasis
S0 Serum tumor marker levels are normal

Stage I

Stage TNM and S Definition
Stage IA T1 The tumor is only in the testicle and epididymis;tunica albuginea
N0 No regional lymph node metastasis
M0 No distant metastasis
S0 Serum tumor marker levels are normal
Stage IB T2, T3 or T4 The tumor may have spread to the spermatic cord or scrotum, and may have grown into lymph or blood vessels
N0 No regional lymph node metastasis
M0 No distant metastasis
S0 Serum tumor marker levels are normal
Stage IS Any T 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
N0 No regional lymph node metastasis
M0 No distant metastasis
S1, S2 or S3 One or more serum tumor markers are higher than normal

Stage II

Stage TNM and S Definition
Stage IIA Any T 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
N1 There is regional lymph node metastasis (cancer cells in 1–5 lymph nodes near the testicle; none of the lymph nodes are larger than 2 cm in diameter)
M0 No distant metastasis
S0 or S1 Serum tumor marker levels are normal or slightly high
Stage IIB Any T 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
N2 There is regional lymph node metastasis (cancer cells are in one lymph node that is 2–5 cm in diameter; cancer cells are in more than 5 lymph nodes but none of the lymph nodes are larger than 5 cm in diameter); extranodal tumor extension
M0 No distant metastasis
S0 or S1 Serum tumor marker levels are normal or slightly high
Stage IIC Any T 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
N3 There is regional lymph node metastasis (the lymph nodes with cancer are larger than 5 cm in diameter)
M0 No distant metastasis
S0 or S1 Serum tumor marker levels are normal or slightly high

Stage III

Stage TNM and S Definition
Stage IIIA Any T 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
Any N No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumor extension
M1a There is distant metastasis
S0 or S1 Serum tumor marker levels are normal or slightly high
Stage TNM and S Definition
Stage IIIB Any T 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
N1, N2 or N3 There is regional lymph node metastasis; extranodal tumor extension
M0 No distant metastasis
S2 Serum tumor marker levels are high
Stage IIIB Any T 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
Any N No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumor extension
M1a There is distant metastasis
S2 Serum tumor marker levels are high
Stage TNM and S Definition
Stage IIIC Any T 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
N1, N2 or N3 There is regional lymph node metastasis; extranodal tumor extension
M0 No distant metastasis
S3 Serum tumor marker levels are very high
Stage IIIC Any T 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
Any N No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumor extension
M1a There is distant metastasis
S3 Serum tumor marker levels are very high
Stage IIIC Any T 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
Any N No regional lymph node metastasis; there is regional lymph node metastasis; extranodal tumor extension
M1b There is distant metastasis to an organ other than the lung, such as the liver or a bone
Any S Serum tumor marker levels are normal, above normal or very high

References

  1. Benson CB (August 1988). "The role of ultrasound in diagnosis and staging of testicular cancer". Semin Urol. 6 (3): 189–202. PMID 3072643.
  2. Marth D, Scheidegger J, Studer UE (1990). "Ultrasonography of testicular tumors". Urol. Int. 45 (4): 237–40. doi:10.1159/000281715. PMID 2163557.
  3. Testicular cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/testicular/staging/?region=ab Accessed on October, 13 2015


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