ABSTRACTBackground:To evaluate the association of demographic and clinicopathological characteristics with the survival of patients with testicular mixed teratoma and seminoma (TMTS).Methods:The data of 3296 eligible patients with TMTS who underwent surgery between 2010 and 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and cancer-specific survival (CSS) were determined using the Kaplan–Meier survival curves. The association of demographic and clinicopathological characteristics with the OS and CSS of patients with TMTS was assessed using the Cox proportional hazard regression model.Results:The number of patients with TMTS increased annually. In Kaplan–Meier analyses, TMTS patients with advanced T stage (P < 0.001 for OS and P < 0.001 for CSS), lymph node metastasis (P < 0.001 for OS and P < 0.001 for CSS), distant metastasis (P < 0.001 for OS and P < 0.001 for CSS), no regional lymph node resection (P = 0.003 for OS and P = 0.002 for CSS), large tumor size (P = 0.001 for OS and P = 0.001 for CSS), and LVI (P < 0.001 for OS and P < 0.001 for CSS) exhibited inferior OS and CSS. Moreover, distant metastasis (HR 11.224, P < 0.001; HR 15.817, P < 0.001) and regional lymph node resection (HR 0.425, P = 0.003; HR 0.366, P = 0.004) were identified as independent prognostic factors for OS and CSS in patients with TMTS through multivariable analyses.Conclusions:Distant metastasis and lymph node metastasis were deemed important prognostic factors for OS and CSS in patients with TMTS. Therefore, a comprehensive understanding and clinical assessments of these prognostic factors are necessary before tailoring clinical management and treatment plan specified for patients with TMTS.