Wednesday, April 22, 2009

53 - Testicular cancer (Germ cell tumor) staging and treatment

Stage Extent of Disease Seminoma Nonseminoma
IA Testis only, no vascular/lymphatic invasion (T1) Radiation therapy RPLND or observation
IB Testis only, with vascular/lymphatic invasion (T2), or extension through tunica albuginea (T2), or involvement of spermatic cord (T3) or scrotum (T4) Radiation therapy RPLND
IIA Nodes < 2 cm Radiation therapy RPLND or chemotherapy often followed by RPLND
IIB Nodes 2–5 cm Radiation therapy RPLND +/– adjuvant chemotherapy or chemotherapy followed by RPLND
IIC Nodes > 5 cm Chemotherapy Chemotherapy, often followed by RPLND
III Distant metastases Chemotherapy Chemotherapy, often followed by surgery (biopsy or resection)

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