People with testicular cancer may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person's medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor's best estimate of how cancer will affect a person, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together, and they both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic factors for testicular cancer.
Type of cancer
- 90% of seminomas and 56% of non-seminomas have a good prognosis. Approximately 16% of non-seminomas have a poor outlook in advanced stages, while seminomas are more responsive to treatment even in advanced stages.
Size of tumour
Tumours greater than 6 cm may indicate a higher stage of seminoma. The tumour size does not indicate a higher stage of non-seminoma.
Retroperitoneal lymph nodes
The presence of testicular cancer in the retroperitoneal lymph nodes indicates more advanced disease.
Distant metastases
Testicular cancer that has spread to the lungs or other distant sites indicates a poor prognosis.
Serum tumour marker levels
High serum tumour marker levels are usually associated with advanced stages of testicular cancer.
Testicular tumours are divided into groups based on how well they are expected to respond to treatment.
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Good risk | All of the following must apply: - tumour found only in the testicle or the area outside or on the wall at the back of the abdomen (retroperitoneum)
- no spread to organs other than the lungs
- all tumour markers slightly above normal
Approximately 56% of non-seminomas | IS (S1) IIA (S1) IIB (S1) IIC (S1) IIIA | All of the following must apply: - no spread to organs other than the lungs
- tumour marker levels:
- AFP – normal
- HCG – any level
- LDH – any level
Approximately 90% of seminomas | IIC IIIA IIIB IIIC |
Intermediate risk | All of the following must apply: - tumour found in one testicle only or in the retroperitoneum
- no spread to organs other than the lungs
- level of any one tumour marker more than slightly above normal
Approximately 28% of non-seminomas | IS (S2) IIC (S2) IIIB | All of the following must apply: - spread to organs other than the lungs
- tumour marker levels:
- AFP – normal
- HCG – any level
- LDH – any level
Approximately 10% of seminomas | IIIC with no lung spread |
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