Seminoma Testicular Cancer Staging 

Updated: Jul 05, 2017
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  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