Stages of Testicular Cancer

The TNM staging system for testicular cancer evaluates three aspects of the disease, including information about the primary tumor (T), the lymph nodes (N), and the presence of distant metastasis (M). The higher numbers reflect a greater degree of abnormality and spread.

TNM staging includes:

Tumor (T) Stage:

• TX means that the primary tumor cannot be assessed.
• T0 means that there is no evidence of a primary tumor.
• Tis (in situ) means that intratubular cancer exists without having spread to other areas.
• T1 means that the tumor is limited to the testis and epididymis, without having spread to nearby blood vessels.
• T2 means that the tumor is in the blood vessels or the thin tissue layer surrounding the inside of the scrotum.
• T3 means that the tumor is in the spermatic cord.
• T4 means that the tumor is in the wall of the scrotum.

Nodal (N) Stage:

• N0 means that there is no lymph node involvement.
• N1 means that the cancer has spread to the lymph node or nodes, each 2 centimeters or less in size.
• N2 means that the cancer has spread to the lymph node or nodes, the largest more than 2 centimeters but not more than 5 centimeters in size.
• N3 means that the cancer has spread to lymph node or nodes, more than 5 centimeters in size.

Metastasis (M) Stage:

• M0 means that there is no distant metastasis. The cancer has not spread.
• M1 means that there is distant metastasis. The cancer has spread.
• M1a means that the cancer has spread to lymph nodes in other areas of the body (nonregional lymph nodes) or to the lungs.
• M1b means that the cancer has spread to places other than nonregional lymph nodes and lungs.