Testis Staging

Question 1

Testis

pTis pT1 Staging

Answer 1

pTis -> Germ cell neoplasia in situ
pT1 -> Limited to testis without LVI
pT1a -> Seminoma less than 3cm
pT1b -> Seminoma greater than 3cm

Question 2

Testis

pT2 Staging

Answer 2

pT2 -> Tumor limited to testis with LVI, invading hilar soft tissue, epididymis or tunica albuginea

Question 3

Testis

pT3

Answer 3

pT3 -> Invading spermatic cord

Question 4

Testis

pT4

Answer 4

pT4 -> Invades scrotum

Question 5

Testis

cN Staging

Answer 5

cN1 -> RP LNs less than 2cm
cN2 -> RP LNs between 2-5cm
cN3 -> RP LNs greater than 5cm

Question 6

Testis

pN Staging

Answer 6

pN1 -> RP LNs less than 2cm and less than 5 positive nodes
pN2 -> RP LNs between 2-5cm or more than 5 positive nodes or ENE
pN3 -> RP LNs greater than 5cm

Question 7

Testis

M staging

Answer 7

M1a -> Non RP LNs or pulmonary metastasis
M1b -> Visceral metastasis

Question 8

Testis

S Staging

Answer 8

S1 -> AFP less than 1,000; BCG less than 5,000; LDH less than 1.5xN
S2 -> AFP 1,000-10,000; BCG 5,000-50,000; LDH 1.5xN to 10xN
S3 -> AFP greater than 10,000; BCG greater than 50,000; LDH greater than 10xN

Question 9

Testis

Stage I

Answer 9

Stage Ia -> pT1 N0 M0 S0
Stage Ib -> pT2-4 N0 M0 S0
Stage Is -> pT1-4 N0 M0 S1-3

Question 10

Testis

Stage II

Answer 10

Stage IIa -> T1-4, N1, M0, S0-1
Stage IIb -> T1-4, N2, M0, S0-1
Stage IIc -> T1-4, N3, M0, S0-1

Question 11

Testis

Stage III

Answer 11

Stage IIIa -> T1-4, N0-3, M1a, S0-1
Stage IIIb -> T1-4, N0-3, M1a, S2
Stage IIIc -> T1-4, N0-3, M1a-M1b, S0-3

Question 12

Testis

Risk Categories

Answer 12

Seminoma Good Risk -> no nonpulmonary mets
Seminoma Intermediate Risk -> visceral mets
NSGCT Good Risk -> Stage IIIa or less with testis or RP primary tumor
NSGCT Intermediate Risk -> Stage IIIb with testis or RP primary
NSGCT Poor Risk -Stage IIIc or Mediastinal primary