Testis: Staging

Primary Tumour:

• Tis
• intratubular germ cell neoplasia only
• T1
• limited to the testis and epididymis, without lymph/vascular invasion
• may invade tunica albuginea but not tunica vaginalis
• T2
• T1 with lymph/vascular invasion, OR
• Invading tunica vaginalis
• T3
• invading spermatic cord
• T4
• invading scrotum

Regional Lymph Nodes:

•  N1
• 5 or fewer positive nodes, AND
• less than 2cm lymph node mass
• N2
• More than 5 nodes positive, OR
• 2-5cm lymph node mass, OR
• extranodal extension
• N3
• Lymph node mass >5cm

Distant Metastasis:

•  M1a
• non-regional lymph nodes, OR
• pulmonary mets
• M1b
• Any other distant mets

Other Important Prognostic Factors:

• >80% embryonal component worsens prognosis
• >50% teratoma component improves prognosis