Testicular Cancer: Probability of Residual Teratoma and/or non-Teratomatous Germ Cell Tumor on Pathology After Post-Chemotherapy Retroperitoneal Lymph Node Removal

This nomogram is for patients who have undergone first-line chemotherapy for a type of testicular cancer called metastatic non-seminomatous germ cell tumor. This tool is designed to help predict the likelihood of finding active cancer or a type of tumor called teratoma in tissue removed during retroperitoneal lymph node dissection, which is a surgery to remove lymph nodes from the back of the abdomen (the retroperitoneal area).

Results produced by this tool are based on data from patients treated at MSK, a large research institution with surgeons who perform a high volume of testicular cancer procedures. All results must be understood in the context of each patient’s specific treatment plan. Patients and caregivers using this tool should discuss the result with the patient’s physician.

To gather the information required to use this nomogram, use our worksheet.

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cm (0 to 25)
Note: This measurement should be done in the axial plane (i.e., not the craniocaudal plane) and should be the size of the largest dimension of the largest residual node.
More on clinical tumor stage
The global standard in testicular cancer staging is the TNMS Staging System, which uses tumor, lymph node, metastasis, and serum tumor marker (TNMS) classifications to describe the extent of cancer in a patient's body at the time of their initial diagnosis. The TNMS stages are then further categorized into three broad clinical stages (I, II, III).
More on the IGCCCG classification system

The IGCCCG classification is a prognostic system for patients with metastatic germ cell tumors. It categorizes patients into good, intermediate, and poor risk groups based on tumor type, primary site, location of metastases, and blood levels of tumor markers.

For more information, please refer to the paper published in the Journal of Clinical Oncology.

Were cancer cells found in the lymphatic or blood vessels in the primary orchiectomy specimen?
Note: This is often reported in the orchiectomy pathology report and abbreviated as LVI.
Was teratoma present in the primary tumor / orchiectomy specimen?
Note: This is reported in the orchiectomy pathology report.
What is teratoma?
Teratoma is a histologic sub-type of germ cell tumor.
Was yolk sac tumor present in the primary tumor / orchiectomy specimen?
Note: This is reported in the orchiectomy pathology report.
What is yolk sac tumor?
Yolk sac tumor is a histologic sub-type of testicular germ cell tumors.