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TNM and Stage Groupings > Testis
Testis
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| pTX |
Primary tumor cannot be assessed |
| pT0 |
No evidence of primary tumor (e.g., histologic scar in testis) |
| pTis |
Intratubular germ cell neoplasia (carcinoma in situ) |
| pT1 |
Tumor limited to the testis and epididymis without vascular/lymphatic invasion;
tumor may invade into the tunica albuginea but not the tunica vaginalis |
| pT2 |
Tumor limited to the testis and epididymis with vascular/lymphatic invasion, or
tumor extending through the tunica albuginea with involvement of the tunica
vaginalis |
| pT3 |
Tumor invades the spermatic cord with or without vascular/lymphatic invasion |
| pT4 |
Tumor invades the scrotum with or without vascular/lymphatic invasion |
The extent of primary tumor is usually classified after radical orchiectomy and,
for this reason, a pathologic stage is assigned.
* Except for pTis and pT4, extent of primary tumor is classified by radical orchiectomy.
TX may be used for other categories in the absence of radical orchiectomy.
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph nodes cannot be assessed |
| N0 |
No regional lymph node metastasis |
| pN1 |
Metastasis with a lymph node mass 2 cm or less in greatest dimension and less
than or equal to 5 nodes positive, none more than 2 cm in greatest dimension |
| pN2 |
Metastasis with a lymph node mass more than 2 cm but not more than 5 cm in
greatest dimension; or more than 5 nodes positive, none more than 5 cm; or
evidence of extranodal extension of tumor |
| pN3 |
Metastasis with a lymph node mass more than 5 cm in greatest dimension |
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Distant metastasis |
| M1a |
No regional nodal or pulmonary metastasis |
| M1b |
Distant metastasis other than to non-regional lymph nodes and lung |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
S (serum tumor markers) |
| 0 |
pTis |
N0 |
M0 |
S0 |
| I |
pT1-4 |
N0 |
M0 |
SX |
| IA |
pT1 |
N0 |
M0 |
S0 |
| IB |
pT2 |
N0 |
M0 |
S0 |
| IB |
pT3 |
N0 |
M0 |
S0 |
| IB |
pT4 |
N0 |
M0 |
S0 |
| IS |
Any pT/TX |
N0 |
M0 |
S1-3 (post orchiectomy) |
| II |
Any pT/TX |
N1-3 |
M0 |
SX |
| IIA |
Any pT/TX |
N1 |
M0 |
S0 |
| IIA |
Any pT/TX |
N1 |
M0 |
S1 |
| IIB |
Any pT/TX |
N2 |
M0 |
S0 |
| IIB |
Any pT/TX |
N2 |
M0 |
S1 |
| IIC |
Any pT/TX |
N3 |
M0 |
S0 |
| IIC |
Any pT/TX |
N3 |
M0 |
S1 |
| III |
Any pT/TX |
Any N |
M1 |
SX |
| IIIA |
Any pT/TX |
Any N |
M1a |
S0 |
| IIIA |
Any pT/TX |
Any N |
M1a |
S1 |
| IIIB |
Any pT/TX |
N1-3 |
M0 |
S2 |
| IIIB |
Any pT/TX |
Any N |
M1a |
S2 |
| IIIC |
Any pT/TX |
N1-3 |
M0 |
S3 |
| IIIC |
Any pT/TX |
Any N |
M1a |
S3 |
| IIIC |
Any pT/TX |
Any N |
M1b |
Any S |
PROGNOSTIC FACTORS (SITE-SPECIFIC FACTORS)
| Serum Tumor Markers (S) |
Definition |
| SX |
Marker studies not available or not performed |
| S0 |
Marker study levels within normal limits |
| S1 |
LDH < 1.5 X N* AND hCG (mlu/ml) < 5000 AND AFP (ng/ml) < 1000 |
| S2 |
LDH 1.5 –10 x N OR hCG (mlu/ml) 5000–50,000 OR AFP (ng/ml) 1000–10,000 |
| S3 |
LDH > 10 x N OR hCG (mlu/ml) > 50,000 OR AFP (ng/ml) > 10,000 |
*N indicates the upper limit of normal for the LDH assay.
Serum tumor marker levels should be measured prior to orchiectomy for assignment of S category.
The only exception is for stage grouping classification of Stage IS in which persistent elevation of
serum tumor markers following orchiectomy is required.
