Stage ii tre a t m e n t stage ii seminoma stage ii

Stage II Tre a t m e n t
Stage II seminoma. Stage II
seminoma is classified as bulky
(tumors larger than 5 cm on CT
scan) or nonbulky disease. Stage II
nonbulky disease has a cure rate of
90% with radiation. The standard
treatment is a radical inguinal
o rchiectomy followed by radiation
therapy to the retroperitoneal
lymph nodes. The treatment for
bulky stage II seminomas consists
of a radical inguinal orc h i e c t o m y
followed by radiation and chemo-
t h e r a p y. Combination chemothera-
py with cisplatin is effective tre a t-
ment with surg e ry and radiation
for stage II disease (NCI, 2008b).
Table 3.
Tumor Node Metastasis Definitions for Testicular Cancer
Primary Tumor (T)
TX: The pri m a ry tumor cannot be assessed.
T0: There is no evidence of pri m a ry tumor.
Tis: Carcinoma in situ (noninvasive cancer cells).
T1: The tumor has not spread beyond the testicle and the narrow tubules
next to the testicles where sperm undergo final maturation (epididymis).
Cancer cells are not found inside blood vessels or lymph vessels next to
the tumor. The cancer may have grown through the inner layer sur-
rounding the testicle (tunica albuginea) but not the outer layer cove ri n g
the testicle (tunica vaginalis).
T2: Similar to T1 except that the cancer has spread to blood vessels, lym-
phatic vessels, or the tunica vaginalis.
T3: The tumor invades the spermatic cord (which contains blood vessels,
lymphatic vessels, nerve s, and the vas deferens).
T4: The tumor invades the skin surrounding the testicles (scrotum).
Regional Lymph Nodes (N)
NX: Regional (nearby) lymph nodes cannot be assessed.
N0: No metastasis (spread) to regional lymph nodes is seen on x-rays.
N1: There is metastasis in at least one lymph node, but no lymph node is
larger than 2 cm (about 3/4 inch) in any dimension.
N2: There is metastasis in at least one lymph node that is larger than 2 cm
but is not bigger than 5 cm (2 inches) in any dimension.
N3: There is metastasis to at least one lymph node that is larger than 5 cm
in any dimension.
If the lymph nodes were taken out during surgery, there is a slightly different clas-
sification:
pNX: Regional (nearby) lymph nodes cannot be assessed.
pN0: There is no metastasis to regional lymph nodes.
pN1: There is metastasis (spread) to one to five lymph nodes, with no lymph
node larger than 2 cm (about 3/4 inch) across in greatest dimension.
pN2: There is metastasis in at least one lymph node that is bigger than 2 cm
but not larger than 5 cm; or metastasis to more than five lymph nodes
that are not bigger than 5 cm (one inch) across (in greatest dimension);
or the cancer is growing out the side of the lymph node.
pN3: There is metastasis to at least one lymph node that is bigger than 5 cm.
Distant Metastasis (M)
MX: Distant metastasis cannot be assessed.
M0: There is no distant metastasis (no spread to lymph nodes outside the
area of the tumor or other organs, such as the lungs).