Adolescent and Young Adult Testicular Germ Cell Tumors: Special Considerations
Table 1
AJCC versus COG staging for testicular tumors [5].
Stage
AJCC
COG
I
pT1-4N0M0S0 IA: pT1N0M0S0 IB: pT2-4N0M0S0 IS: pT1-4N0M0S1-3
Tumor limited to testis, completely resected by high inguinal orchiectomy; no clinical, radiographic, or histologic evidence of disease beyond the testis Normal or unknown tumor markers at diagnosis must have negative ipsilateral RPLND to confirm stage I disease if imaging shows LNs > 2 cm Scrotal orchiectomy with high ligation of the cord is also considered stage I
Transscrotal biopsy; microscopic disease in scrotum or high in spermatic cord (< 5 mm from proximal cord margin) Failure of tumor markers to normalize or decrease with an appropriate half-life