Background: 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
Objective: To explore the prognostic factors for Progression-Free Survival (PFS) and construct a
nomogram model for patients with early-stage TGCT after radical orchiectomy.
Methods: 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.
Results: 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.
Conclusion: 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.