Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, P.R. China
Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY 11439, USA
Recent Pat Anticancer Drug Discov. 2021;16(1):44-53. doi: 10.2174/1574892816666210211092108.
Testicular Germ Cell Tumor (TGCT) is the most common malignant tumor in young men, but there is a lack of a prediction model to evaluate the prognosis of patients with TGCT.
To explore the prognostic factors for Progression-Free Survival (PFS) and construct a nomogram model for patients with early-stage TGCT after radical orchiectomy.
Patients with TGCT from The Cancer Genome Atlas (TCGA) database were used as the training cohort; univariate and multivariate cox analysis was performed. A nomogram was constructed based on the independent prognostic factors. Patients from the Nanfang Hospital affiliated with Southern Medical University were used as the cohort to validate the predictive ability using the nomogram model. Harrell's concordance index (C-index) and calibration plots were used to evaluate the nomogram.
A total of 110 and 62 patients with TGCT were included in the training cohort and validation cohort, respectively. Lymphatic Vascular Invasion (LVI), American Joint Committee on Cancer (AJCC) stage and adjuvant therapy were independent prognostic factors in multivariate regression analyses and were included to establish a nomogram. The C-index in the training cohort for 1- , 3-, and 5-year PFS were 0.768, 0.74, and 0.689, respectively. While the C-index for 1-, 3-, and 5- year PFS in the external validation cohort were 0.853, 0.663 and 0.609, respectively. The calibration plots for 1-, 3-, and 5-year PFS in the training and validation cohort showed satisfactory consistency between predicted and actual outcomes. The nomogram revealed a better predictive ability for PFS than AJCC staging system.
The nomogram as a simple and visual tool to predict individual PFS in patients with TGCT could guide clinicians and clinical pharmacists in therapeutic strategy.
睾丸生殖细胞肿瘤（TGCT）是年轻男性中最常见的恶性肿瘤，但缺乏评估 TGCT 患者预后的预测模型。
探讨无进展生存（PFS）的预后因素，并构建根治性睾丸切除术治疗早期 TGCT 患者的列线图模型。
采用癌症基因组图谱（TCGA）数据库中的 TGCT 患者作为训练队列；进行单因素和多因素 cox 分析。基于独立的预后因素构建列线图。南方医科大学南方医院的患者作为队列，使用列线图模型验证预测能力。采用 Harrell 一致性指数（C-index）和校准图评估列线图。
训练队列和验证队列分别纳入 110 例和 62 例 TGCT 患者。淋巴血管侵犯（LVI）、美国癌症联合委员会（AJCC）分期和辅助治疗是多因素回归分析中的独立预后因素，并被纳入建立列线图。训练队列中 1 年、3 年和 5 年 PFS 的 C-index 分别为 0.768、0.74 和 0.689，而外部验证队列中 1 年、3 年和 5 年 PFS 的 C-index 分别为 0.853、0.663 和 0.609。训练和验证队列中 1 年、3 年和 5 年 PFS 的校准图显示预测结果与实际结果之间具有良好的一致性。列线图在预测 TGCT 患者 PFS 方面的预测能力优于 AJCC 分期系统。
作为一种简单直观的工具，列线图可预测 TGCT 患者的个体 PFS，有助于指导临床医生和临床药师制定治疗策略。
