AFP and neoplasm: They are widely staged by the TNMS (Tumor-Nodal-Metastasis-Serum Tumor Marker) system set forth by the American Joint Commission on cancer (AJCC) staging [16] (Table 1), combining the local tumor extent on surgical pathology after orchiectomy, regional and distal lymph nodes and distant metastases involvement, and finally, post-orchiectomy serum marker levels, including alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (HCG) and Lactate Dehydrogenase (LDH).