| Primary Tumor T Stage (pT) |
| pTO |
No evidence of tumor in testis (scar may be present) |
| pTis |
Intratubular germ cell neoplasia (CIS) |
| pT1 |
Tumor limited to the testis/epdidymis without vascular or lymphatic invasion; tumor may invade the tunica albuginea but not the tunica vaginalis |
| pT2 |
Tumor limited to the testis/epididymis with vascular or lymphatic invasion or tumor extending to and involving the tunica vaginalis |
| pT3 |
Tumor invading the spermatic core ± vascular or lymphatic invasion |
| pT4 |
Tumor invading the scrotum ± vascular or lymphatic invasion |
| Regional Nodes (N) |
| pNX |
Regional lymph nodes cannot be assessed |
| pNO |
No regional lymph node metastasis |
| pN1 |
Metastasis with a lymph node mass, 2 cm or less in greatest dimension and less than or equal to 5 nodes positive, none more than 2 cm in greatest dimension |
| pN2 |
Metastasis with a lymph node mass, more than 2 cm but not more than 5 cm in greatest dimension;
or more than 5 nodes positive, none more than 5 cm; or evidence of extra nodal extension of tumor |
| pN3 |
Metastasis with a lymph node mass more than 5 cm in greatest dimension |
| Distant Metastasis (M) |
| MX |
Distant metastasis cannot be assessed |
| MO |
No distant metastasis |
| M1 |
Distant metastasis |
| Mla |
Nonregional nodal or pulmonary metastasis |
| Mlb |
Distant metastasis other than to nonregional lymph node and lungs |
| Serum Tumor Markers (S) |
| SX |
Marker studies not available |
| SO |
Markers within normal limits |
| S l |
LDH < 1.5 x Normal AND hCG < 5000 mIu/mL AND AFP < 1000 ng/mL |
| S2 |
LDH 1.5-10 x N OR hCG 5,000 to 50,000 mIu/mL OR AFP 1000-10,000 ng/mL |
| S3 |
LDH > 10 x N OR hCG > 50,000 mIu/mL OR AFP > 10,000 ng/mL |
| Definitions of Clinical Stages for Testis Cancer |
| I or A Tumor |
Tumor confined to the testicle or cord structure |
| IIA or B 1 |
Microscopic regional lymph node involvement in < 6 nodes |
| IIB or B2 |
Microscopic involvement in > 6 regional lymph nodes or gross nodal involvement < 6 cm |
| IIC or B2 |
Gross nodal involvement > 6 cm in one lymph node or as an aggregate of lymph nodes |
| III or C |
Disease above the diaphragm or involving abdominal organs |
| (Regional Nodes) Clinical |
| NX |
Regional lymph nodes cannot be assessed |
| NO |
No regional lymph node metastasis |
| N1 |
Metastasis with a lymph node mass 2 cm or less in greatest dimension; or multiple lymph nodes, none more than 2 cm in greatest dimension |
| N2 |
Metastasis with a lymph node mass, more than 2 cm but not more than 5 cm in greatest dimension; or multiple lymph nodes any one mass greater than 2 cm but not more than 5 cm in greatest dimension |
| N3 |
Metastasis with a lymph node mass more than 5 cm in greatest dimension |
Testicular Cancer 
