Scandura G, et al. - Age, tumor size, invasion of vessels, hilar soft tissue, rete testis, epididymis, spermatic cord, tunica vaginalis and tumor at spermatic cord margin were evaluated and associated with clinical stage (CS) at the presentation in order to examine pathological predictors of metastatic disease at presentation in 332 testicular seminomas. The most robust predictors of metastatic disease at presentation were tumor size and epididymal invasion. Results confirmed variations in American Joint Committee on Cancer Tumor-Node-Metastasis staging eighth edition, however, it proposed a tumor size of 4 cm as the better cutoff value.