Version May 2024
| Primary tumor (T) | |
| Clinical T (cT) | |
| cT category | cT criteria |
| cTX | Primary tumor cannot be assessed |
| cT0 | No evidence of primary tumor |
| cTis | Germ cell neoplasia in situ |
| cT4 | Tumor invades scrotum with or without vascular/lymphatic invasion |
| NOTE: Except for Tis confirmed by biopsy and T4, the extent of the primary tumor is classified by radical orchiectomy. TX may be used for other categories for clinical staging. | |
| Pathological T (pT) | |
| pT category | pT criteria |
| pTX | Primary tumor cannot be assessed |
| pT0 | No evidence of primary tumor |
| pTis | Germ cell neoplasia in situ |
| pT1 | Tumor limited to testis (including rete testis invasion) without lymphovascular invasion |
| pT1a* | Tumor smaller than 3 cm in size |
| pT1b* | Tumor 3 cm or larger in size |
| pT2 | Tumor limited to testis (including rete testis invasion) with lymphovascular invasion or Tumor invading hilar soft tissue or epididymis or penetrating visceral mesothelial layer covering the external surface of tunica albuginea with or without lymphovascular invasion |
| pT3 | Tumor directly invades spermatic cord soft tissue with or without lymphovascular invasion |
| pT4 | Tumor invades scrotum with or without lymphovascular invasion |
| * Subclassification of pT1 applies only to pure seminoma. | |
| Regional lymph nodes (N) | |
| Clinical N (cN) | |
| cN category | cN criteria |
| cNX | Regional lymph nodes cannot be assessed |
| cN0 | No regional lymph node metastasis |
| cN1 | Metastasis with a lymph node mass 2 cm or smaller in greatest dimension or Multiple lymph nodes, none larger than 2 cm in greatest dimension |
| cN2 | Metastasis with a lymph node mass larger than 2 cm but not larger than 5 cm in greatest dimension or Multiple lymph nodes, any one mass larger than 2 cm but not larger than 5 cm in greatest dimension |
| cN3 | Metastasis with a lymph node mass larger than 5 cm in greatest dimension |
| Pathological N (pN) | |
| pN category | pN criteria |
| pNX | Regional lymph nodes cannot be assessed |
| pN0 | No regional lymph node metastasis |
| pN1 | Metastasis with a lymph node mass 2 cm or smaller in greatest dimension and less than or equal to five nodes positive, none larger than 2 cm in greatest dimension |
| pN2 | Metastasis with a lymph node mass larger than 2 cm but not larger than 5 cm in greatest dimension; or more than five nodes positive, none larger than 5 cm; or evidence of extranodal extension of tumor |
| pN3 | Metastasis with a lymph node mass larger than 5 cm in greatest dimension |
| Distant metastasis (M) | |
| M category | M criteria |
| M0 | No distant metastases |
| M1 | Distant metastases |
| M1a | Nonretroperitoneal nodal or pulmonary metastases |
| M1b | Nonpulmonary visceral metastases |
| Serum markers (S)¶ | |
| S category | S criteria |
| SX | Marker studies not available or not performed |
| S0 | Marker study levels within normal limits |
| S1 | LDH <1.5 × NΔ and hCG (mIU/mL) <5000 and AFP (ng/mL) <1000 |
| S2 | LDH 1.5 to 10 × NΔ or hCG (mIU/mL) 5000 to 50,000 or AFP (ng/mL) 1000 to 10,000 |
| S3 | LDH >10 × NΔ or hCG (mIU/mL) >50,000 or AFP (ng/mL) >10,000 |
| ¶ Markers used for risk classification are postorchiectomy. Δ N indicates the upper limit of normal for the LDH assay. | |
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