LAUSR

We appreciate the opportunity to respond to the insightful comments made by Prof. Albers [1]. Indeed, we confirm relapse risk for clinical stage I testicular cancer is low after 2 yr, and acknowledge the important contributions of the recent publications by Kollmansberger et al [2] and Daugaard et al [3]. However, the focus of our study was to describe how the risk of relapse changes over time and provide quantifiable estimates for physicians to help them to educate patients returning relapse-free for a surveillance visit (the concept of conditional survival) [4]. The idea is to capitalize on information since orchiectomy (eg, the patient has been relapse-free for 12 mo) to inform on future relapse risk. To date, this has not been formally described for clinical stage I testicular cancer. We agree with Prof. Albers, and describe in our discussion that before changing individual surveillance schedules based on conditional relapse-free predictions, our findings require validation. However, we do feel that our study is the first to raise the possibility that there may be different trends for conditional relapse-free predictions over time within subgroups of patients with clinical stage I disease. Prof. Albers argues that adding any complexity to surveillance could decrease uptake, adherence, and quality when administered outside academic centers. These are all valid points. However, given the current emphasis on cost