Testicular cancer staging: Difference between revisions
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| style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits. | | style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits. | ||
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| style="padding: 5px 5px; background: #DCDCDC;" rowspan= | | style="padding: 5px 5px; background: #DCDCDC;" rowspan=5|Stage IB | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |pT2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | 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;" | | | style="padding: 5px 5px; background: #F5F5F5;" |cN0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] [[metastasis]] | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" |pN0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] [[metastasis]] | | style="padding: 5px 5px; background: #F5F5F5;" |No regional [[lymph node]] [[metastasis]] | ||
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| style="padding: 5px 5px; background: #F5F5F5;" |No distant [[metastasis]] | | style="padding: 5px 5px; background: #F5F5F5;" |No distant [[metastasis]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |S0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |Marker study levels within normal limits. | ||
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| style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIA | | style="padding: 5px 5px; background: #DCDCDC;" rowspan=4|Stage IIA | ||
Revision as of 14:53, 7 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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Testicular cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Testicular cancer staging On the Web |
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American Roentgen Ray Society Images of Testicular cancer staging |
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Risk calculators and risk factors for Testicular cancer staging |
Overview
The diagnostic study of choice for testicular cancer is scrotal ultrasound.
Diagnostic Study of Choice
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).[3]
| Stage | TNM/S | Description |
|---|---|---|
| Stage 0 | pTisb | 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 | Tumor <3 cm in size | |
| pT1b | 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 | Tumor <3 cm in size | |
| pT1b | 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. | |
| 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 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 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 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
- ↑ 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.
- ↑ "Testicular Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute".