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Table 2 Royal Marsden staging classification of testicular germ cell tumours

From: Clinical and genetic aspects of testicular germ cell tumours

Stage Criteria
I no evidence of metastases
IM no clinical evidence of metastases, but persistent elevation of serum tumour markers AFP and/or hCG
II infradiaphragmatic lymph node metastases
   IIA metastases <2 cm in diameter
   IIB metastases 2-5 cm in diameter
   IIC metastases >5 cm in diameter
III supradiaphragmatic lymph node metastases; status A, B, C as for stage II
IV extra lymphatic metastases
   L1 ≤3 lung metastases
   L2 >3 lung metastases, all ≤2 cm in diameter
   L3 >3 lung metastases, one or more >2 cm in diameter
   H+, Br+, Bo+ liver, brain, or bone metastases