Review Article

Adolescent and Young Adult Testicular Germ Cell Tumors: Special Considerations

Table 1

AJCC versus COG staging for testicular tumors [5].

StageAJCCCOG

IpT1-4N0M0S0
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
IIpT1-4N1-3M0S0-1
IIA: pT1-4N1M0S0-1
IIB: pT1-4N2M0S0-1
IIC: pT1-4N3M0S0-1
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
IIIpT1-4N1-3M1S0-1
IIIA: pT1-4N1-3M1aS0-1
IIIB: pT1-4N1-3M0-1bS2
IIIC: pT1-4N1-3M0-1bS3
Retroperitoneal LN involvement without visceral or extraabdominal involvement
LNs > 4 cm by CT or 2–4 cm if biopsy proven metastatic
IVDistant metastasis, including liver