Germ Cell Tumor Staging 

Updated: Jan 08, 2015
  • Author: from Memorial Sloan-Kettering - Elizabeth L Jewell, MD, MHSc; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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TNM and FIGO Staging of Germ Cell Tumors

The American Joint Committee on Cancer (AJCC) TNM classification and the International Federation of Gynecology and Obstetrics (FIGO) staging system for germ cell tumors are listed below (see Tables 1 and 2). [1, 2, 3] Malignant germ cell tumors of the ovary follow the same staging system as epithelial ovarian and primary peritoneal cancers.

Table 1. TNM and FIGO Staging of Ovarian Cancer (Open Table in a new window)

Primary tumor (T)

TNM

FIGO

Definition

TX

 

Primary tumor cannot be assessed

T0

 

No evidence of a primary tumor

T1

I

Tumor confined to the ovaries

T1a

IA

Tumor limited to one ovary, without capsular or surface involvement; cytology from peritoneal washings or ascites negative

T1b

IB

Tumor limited to both ovaries, without capsular or surface involvement; cytology from peritoneal washings or ascites negative

T1c

IC

Tumor limited to one of both ovaries, with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells on cytology of ascites or peritoneal washings

T2

II

Tumor extends beyond ovaries but is limited to the pelvis

T2a

IIA

Extension and/or implants to uterus or tubes; cytology negative

T2b

IIB

Extension and/or implants to other pelvic tissue; cytology negative

T2c

IIC

Pelvic extension and/or implants; malignant cells on cytology of ascites or peritoneal washings

T3

III

Tumor extends to peritoneal cavity outside the pelvis or to regional lymph nodes

T3a

IIIA

Microscopic peritoneal metastasis beyond the pelvis

T3b

IIIB

Macroscopic peritoneal metastasis beyond the pelvis but =2 cm in greatest dimension

T3c

IIIC

Peritoneal metastasis beyond pelvis =2 cm in greatest dimension and/or regional lymph node metastasis

Regional lymph nodes (N)

TNM

FIGO

 

NX

 

Regional lymph nodes cannot be assessed

N0

 

No regional lymph node metastasis

N1

IIIC

Regional (pelvic, para-aortic, inguinal) lymph node metastasis

Distant metastasis (M)

TNM

FIGO

 

M0

 

No distant metastasis

M1

IV

Distant metastasis

Table 2. Anatomic Stages/Prognostic Groups for Ovarian Cancer (Open Table in a new window)

Stage

TNM

IA

T1a

N0

M0

IB

T1b

N0

M0

IC

T1c

N0

M0

IIA

T2a

N0

M0

IIB

T2b

N0

M0

IIC

T2c

N0

M0

IIIA

T3a

N0

M0

IIIB

T3b

N0

M0

IIIC

T3c

Any T

N0

N1

M0

M0

IV

Any T

Any N

M1

The classification of malignant ovarian germ cell tumors is modified from the 2003 World Health Organization histologic classification of tumors of the ovary (see Table 3). [4, 5]

Table 3. Classification of Malignant Ovarian Germ Cell Tumors (Open Table in a new window)

Primitive germ cell tumors

Dysgerminoma

Yolk sac tumor

Embryonal carcinoma

Polyembryoma

Nongestational choriocarcinoma

Mixed germ cell tumor, specify components

Biphasic or triphasic teratomas

Immature teratoma

Mature teratoma (benign)

Monodermal teratoma and somatic-type tumors associated with mature teratoma

Thyroid tumor group

Carcinoid group

Neuroectodermal tumor group

Carcinoma group

Melanocytic group

Sarcoma group

Sebaceous tumor group

Pituitary-type tumor group

Retinal anlage tumor group

Other