Seminoma Testicular Cancer Staging

July 5, 2017

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TNM Classification for Seminoma Testicular Cancer

The TNM classification for seminoma testicular cancer is provided below.

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

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)