Trevino K, et al. - Researchers explored pathologic risk factors for a higher clinical stage in testicular seminomas comparing clinical stage I to advanced clinical stage patients (stages II and III). For this investigation, 211 cases of testicular seminomas were assessed and patient age, tumor size, lymphovascular invasion and rete testis, hilar soft tissue, epididymis, spermatic cord, tunica albuginea, and tunica vaginalis involvement were recorded. The univariate data suggested that tumor size, vascular invasion, invasion of rete testis stroma, epididymis, spermatic cord, and hilar soft tissue predicted to higher clinical stage. Multivariate analysis revealed that only tumor size and vascular invasion remained significant, therefore, this study supported tumor upstaging based only upon the size and vascular invasion.