Population-based cohort study of prognostic factors for relapse in patients with clinical stage I testicular seminoma

Around 20% of patients with clinical stage I seminoma relapse after orchiectomy. The level of evidence supporting the use of currently defined risk factors in decision making is low. A nationwide, population-based cohort study in Denmark investigated prognostic factors for relapse in an unselected cohort of patients with clinical I seminoma with centralized pathology review. The study identified invasion into the testicular hilum, lymphovascular invasion, and elevated preorchiectomy levels of β-human chorionic gonadotropin and lactate dehydrogenase as risk factors for relapse.The estimated 5-year risk of relapse ranged from 6% in patients with none of these risk factors to 62% in patients with all four risk factors.