Published August 2002
Staging (BC Cancer Agency)
- Stage A
- A1
Disease localized to scrotum
- A2
Local extension involving adjacent structures (penis, perineum, testis, cord, pubis) but without evident metastases
- Stage B
Regional metastases - resectable (inguinal or ilioinguinal) - Stage C
Regional metastases, non-resectable - Stage D
Distant metastases (beyond regional nodes)
Staging Diagram
Investigations for Staging
- Chest X-ray
- Culture
- CT scan in selected cases
Carcinoma of the scrotum occurs very rarely in our population. Careful review and consideration should be given before any therapy is initiated.
Stage A
Wide local excision (testis and cord left).
Stage B
Wide local excision (testis and cord left). Staged groin dissection (inguinal when clinically positive).
Stage C & D
Palliative chemotherapy and/or radiotherapy.
(See Skin Cancer recommendations, Non-melanoma)
Following the completion of treatment, all patients need to be monitored for potential recurrence of cancer and complications of therapy. This is needed both for management of the individual patient (where early detection would improve outcome), and to permit periodic review and improvement of current treatment policy.
Often it is felt appropriate to share follow up with the family doctor (and/or the urologist), in which case it is important for the patient to be clear who is responsible for certain aspects of the disease, e.g. symptom control by the family doctor, with advice from the BC Cancer Agency at the doctor's request.
Notification is requested in the event of any of the following:
- Local recurrence at the primary site (particularly in patients with clinically localized disease treated with surgery and/or radiotherapy)
- Metastasis at regional or distant sites
- Complications of therapy especially if acute requiring hospitalization, or chronic and symptomatic
- Death with primary cause and whether cancer or treatment contributed
The event, date, and evidence where appropriate should be sent to the Agency chart where it will come to the attention of the oncologist, and will be available for periodic review by the tumour group. This information is requested annually for patients no longer followed at the BC Cancer Agency.
