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 with TGCT.

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.

背景：睾丸生殖细胞肿瘤（TGCT）是青年男性最常见的恶性肿瘤，但目前缺乏评价TGCT患者预后的预测模型。

目的：探讨无进展生存期（PFS）的预后因素，构建根治性睾丸切除术后早期TGCT患者的列线图模型。

方法：来自癌症基因组图谱（TCGA）数据库的 TGCT 患者被用作训练队列；进行单变量和多变量 cox 分析。基于独立的预后因素构建列线图。以南方医科大学附属南方医院的患者为队列，使用列线图模型验证预测能力。Harrell 的一致性指数 (C-index) 和校准图用于评估列线图。

结果：共有 110 名和 62 名 TGCT 患者分别被纳入训练队列和验证队列。淋巴管浸润 (LVI)、美国癌症联合委员会 (AJCC) 分期和辅助治疗是多变量回归分析中的独立预后因素，并被包括在内以建立列线图。1 年、3 年和 5 年 PFS 训练队列中的 C 指数分别为 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 指数分别为 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和实际结果之间具有令人满意的一致性。列线图显示比 AJCC 分期系统更好的 PFS 预测能力。

结论：列线图作为预测 TGCT 患者个体 PFS 的简单直观工具可以指导临床医生和临床药师制定治疗策略。