Seminoma Testicular Cancer Staging 

Updated: Jan 17, 2014
  • Author: Kush Sachdeva, MD; Chief Editor: Jules E Harris, MD, FACP, FRCPC  more...
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TNM Classification for Seminoma Testicular Cancer

The TNM classification for seminoma testicular cancer is provided below. [1]

Table. TNM Classification for Seminoma Testicular Cancer (Open Table in a new window)

Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Intratubular germ cell neoplasia
T1 Tumor limited to the testis and epididymis or tumor invasion into the tunica albuginea only
T2 Tumor extending through the tunica albuginea with involvement of the tunica vaginalis
T3 Tumor invades the spermatic cord
T4 Tumor invades the scrotum
Regional lymph nodes — clinical (N) or pathologic (pN) staging
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastases to single or multiple lymph nodes, each < 2 cm in size
N2 Metastases to single or multiple lymph nodes, >2 cm but < 5 cm in size
N3 Metastases to lymph node, >5 cm in greatest dimension
Distant metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis
M1a Nonregional nodal or pulmonary metastasis
M1b Distant metastasis other than to nonregional lymph nodes and lungs

Table. Serum tumor markers (Open Table in a new window)

Serum tumor markers
S0 Normal level
SX Unavailable or not performed
S1 Lactate dehydrogenase (LDH) level < 1.5 times normal, human chorionic gonadotropin (HCG) level < 5000 IU/L, alpha-fetoprotein (AFP) level < 1000 ng/mL
S2 LDH 1.5–10 times normal; HCG level, 5000–50,000 IU/L; AFP level, 1000–10,000 ng/mL
S3 LDH >10 times normal; HCG level >50,000 IU/L; AFP level >10,000 ng/mL

Table. Anatomic stage/prognostic groupings (Open Table in a new window)

Stage T N M S



(tumor markers)



0 pTis N0 M0 S0
I pT1–4 N0 M0 SX
IA pT1 N0 M0 S0
IB pT2 N0 M0 S0
pT3 N0 M0 S0
pT4 N0 M0 S0
IS Any pT/TX N0 M0 S1-3
II Any pT/TX N1-3 M0 SX
IIA Any pT/TX N1 M0 S0
Any pT/TX N1 M0 S1
IIB Any pT/TX N2 M0 S0
Any pT/TX N2 M0 S1
IIC Any pT/TX N3 M0 S0
Any pT/TX N3 M0 S1
III Any pT/TX Any N M1 SX
IIIA Any pT/TX Any N M1a S0
Any pT/TX Any N M1a S1
IIIB Any pT/TX N1-3 M0 S2
Any pT/TX Any N M1a S2
IIIC Any pT/TX N1-3 M0 S3
Any pT/TX Any N M1a S3
Any pT/TX Any N M1b Any S