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

		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)