S Category Pathological (Testis)

Note 1 Physician Statement

• 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 Post-orchiectomy S Category

• Code the post-orchiectomy S category (Pathological S) 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 Timing

• Pathological stage values are those based on physician statement or lab values after orchiectomy and prior to adjuvant therapy.

Note 4 Lab values elevated after orchiectomy

• 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 AFP, hCG, LDH

• 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 Normal Serum Tumor Markers (pre-orchiectomy)

• When all the serum tumor markers are normal pre-orchiectomy and they are not repeated post-orchiectomy, code 5.