Testicular cancer staging
- Stage I: Cancer is found only in the testicle. Removing the testicle alone should
cure the patient, though many will choose some form of additional treatment just to be
sure...
- Stage II: Cancer has spread to the lymph nodes in the abdomen. Removing the
testicle alone will not cure the patient, and more treatment is necessary.
- Stage III: Cancer has spread to areas above the diaphragm such as the lungs, neck
or brain. There may be also be cancer in parts of the body such as the bones or liver. In
this situation, chemotherapy is absolutely required. Surgery may also be needed.
- Stage IV: To the best of my knowledge, there is no such thing as Stage IV
testicular cancer. However, it is possible that Stage IV may still be used in some places
in Europe. Suffice to say that Stage IV is probably very similar to Stage III.
- Recurrent: Recurrent disease means that the cancer has come back after it has
been treated. It may recur in the same place or in another part of the body.
Testicular cancer staging - surgical staging information.
In addition to the clinical stage definitions, surgical stage may be designated based
on the results of surgical removal and microscopic examination of tissue.
Stage I - Stage I testicular cancer is limited to the
testis. Invasion of the scrotal wall by tumor or interruption of the scrotal wall by
previous surgery does not change the stage but does increase the risk of spread to the
inguinal lymph nodes, and this must be considered in treatment and follow-up. Invasion of
the epididymis tunica albuginea and/or the spermatic cord also does not change the stage
but does increase the risk of retroperitoneal nodal involvement and the risk of
recurrence. This stage corresponds to AJCC stages I and II.
Stage II - Stage II testicular cancer involves the
testis and the retroperitoneal or para-aortic lymph nodes usually in the region of the
kidney. Retroperitoneal involvement should be further characterized by the number of nodes
involved and the size of involved nodes. The risk of recurrence is increased if more than
5 nodes are involved, if the size of 1 or more involved nodes is larger than 2
centimeters, or if there is extranodal fat involvement. Bulky stage II disease describes
patients with extensive retroperitoneal nodes (>5 centimeters) who require primary
chemotherapy and who have a less favorable prognosis. This stage corresponds to AJCC
stages III and IV (no distant metastasis).
Stage III - Stage III implies spread beyond the
retroperitoneal nodes based on physical examination, x-rays, and/or blood tests. Stage III
is subdivided into nonbulky stage III versus bulky stage III. In nonbulky stage III,
metastases are limited to lymph nodes and lung with no mass larger than 2 centimeters in
diameter. Bulky stage III includes extensive retroperitoneal nodal involvement, plus lung
nodules or spread to other organs such as liver or brain. This stage corresponds to AJCC
stage IV (distant metastasis). |