Testis Serum Markers (S) Pathological (post-orchiectomy )
This input is used for staging
DescriptionS Category Pathological combines the results of post-orchiectomy Alpha Fetoprotein (AFP), Human Chorionic Gonadotropin (hCG) and Lactate Dehydrogenase (LDH) into a summary S value.
Notes**Note 1:** Code the S category as described by the physician. If the S category determined by available lab values or calculated by vendor software differs from the physician statement of the S category, the physician's statement takes precedence. **Note 2:** Code the post-orchiectomy S category according to the table below. This table is also available in AJCC 8th edition, Chapter 59, Testis. * For AFP, a lab value expressed in micrograms per liter (ug/L) is equivalent to the same value expressed in nanograms per milliliter (ng/ml). **Note 3:** Pathological stage values are those based on physician statement or lab values after orchiectomy and prior to adjuvant therapy. **Note 4:** If the initial post-orchiectomy lab values remain elevated, review the subsequent tests and use the lowest lab values (normalization or plateau) prior to adjuvant therapy or before the value rises again. **Note 5:** All three lab values are needed for S0-S1. Only one elevated test is needed to assign S2-3. If any individual test is not available and none of the available tests results meets the S2-3 criterion for that test, assign code 9 (SX). **Note 6:** When all the serum tumor markers are normal pre-orchiectomy and they are not repeated post-orchiectomy, code 5.
NAACCR ItemNAACCR #3924
|0||S0: Marker study levels within normal levels|
|1||S1: At least one of these values is elevated AND - LDH less than 1.5 x N* AND - hCG (mIU/L) less than 5,000 AND - AFP (ng/mL) less than 1,000|
|2||S2: - LDH 1.5 x N* to 10 x N* OR - hCG (mIU/L) 5,000 to 50,000 OR - AFP (ng/mL) 1,000 to 10,000|
|3||S3: Only one elevated test is needed - LDH greater than 10 x N* OR - hcG (mIU/mL) greater than 50,000 OR - AFP (ng/mL) greater than 10,000|
|5||Post orchiectomy serum tumor markers unknown or not done but pre orchiectomy serum tumor markers were normal|
|9||SX: Not documented in medical record S Category Pathological not assessed or unknown if assessed|