Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors

BackgroundPrimary central nervous system (CNS) germ cell tumors (GCTs) are common neoplasms in the CNS of pediatric and adolescent patients. This study aimed to identify prognostic factors associated with CNS GCTs and establish an effective nomogram for predicting overall survival (OS) in patients w...

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Main Authors: Dunchen Yao, Baokui Ye, Hongli Zhang, Long Pan, Dongjie Yao, Xu Li, Chengcheng Guo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1630061/full
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author Dunchen Yao
Baokui Ye
Hongli Zhang
Long Pan
Dongjie Yao
Xu Li
Chengcheng Guo
author_facet Dunchen Yao
Baokui Ye
Hongli Zhang
Long Pan
Dongjie Yao
Xu Li
Chengcheng Guo
author_sort Dunchen Yao
collection DOAJ
description BackgroundPrimary central nervous system (CNS) germ cell tumors (GCTs) are common neoplasms in the CNS of pediatric and adolescent patients. This study aimed to identify prognostic factors associated with CNS GCTs and establish an effective nomogram for predicting overall survival (OS) in patients with CNS GCTs.MethodsThe development cohort including 1166 CNS GCTs patients was selected from Surveillance, Epidemiology, and End Results (SEER) program between 2000 and 2021. An additional 165 CNS GCTs patients treated at the Sun Yat-sen University Cancer Center (SYSUCC) between 1997 and 2019 were included as validation cohort.ResultsThe nomogram incorporated the variables screened by multivariate Cox regression analysis, which included age, sex, histopathology, dissemination, tumor size, radiotherapy, and chemotherapy. The model demonstrated good discriminative performance, with C-index of 0.773 (95% CI, 0.734 - 0.812) and 0.712 (95% CI, 0.599- 0.825) in the development and validation cohorts, respectively. Calibration curves and area under the time-dependent receiver operating characteristic curve (time-dependent AUC) verified the superiority of our nomogram for clinical usefulness. Decision curve analysis (DCA) further illustrated the potential clinical value of the nomogram for treatment decision-making. Additionally, we established a comprehensive risk grouping system that effectively categorized patients into distinct prognostic groups based on their predicted outcomes.ConclusionA precise prognostic nomogram was developed for patients with CNS GCTs, utilizing seven independent prognostic factors. It demonstrated satisfactory performance and clinical usability, aiding clinicians in accurately estimating prognosis and guiding the treatment and long-term management of patients with CNS GCTs.
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spelling doaj-art-348e16b8f102419ea56ed53da5da33d02025-08-20T04:14:09ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16300611630061Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumorsDunchen Yao0Baokui Ye1Hongli Zhang2Long Pan3Dongjie Yao4Xu Li5Chengcheng Guo6Department of Oncology, The Second People’s Hospital of Guiyang, Guiyang, ChinaDepartment of Intensive Care Unit, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University, Guangzhou, ChinaDepartment of Oncology, Guizhou Provincial People’s Hospital, Guiyang, ChinaCordeliers Research Center, Sorbonne Université, Inserm, Université Paris Cité, Paris, FranceDepartment of Neurology, Zhenyuan County Hospital, Zhenyuan, ChinaDepartment of Oncology, The Second People’s Hospital of Guiyang, Guiyang, ChinaDepartment of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University, Guangzhou, ChinaBackgroundPrimary central nervous system (CNS) germ cell tumors (GCTs) are common neoplasms in the CNS of pediatric and adolescent patients. This study aimed to identify prognostic factors associated with CNS GCTs and establish an effective nomogram for predicting overall survival (OS) in patients with CNS GCTs.MethodsThe development cohort including 1166 CNS GCTs patients was selected from Surveillance, Epidemiology, and End Results (SEER) program between 2000 and 2021. An additional 165 CNS GCTs patients treated at the Sun Yat-sen University Cancer Center (SYSUCC) between 1997 and 2019 were included as validation cohort.ResultsThe nomogram incorporated the variables screened by multivariate Cox regression analysis, which included age, sex, histopathology, dissemination, tumor size, radiotherapy, and chemotherapy. The model demonstrated good discriminative performance, with C-index of 0.773 (95% CI, 0.734 - 0.812) and 0.712 (95% CI, 0.599- 0.825) in the development and validation cohorts, respectively. Calibration curves and area under the time-dependent receiver operating characteristic curve (time-dependent AUC) verified the superiority of our nomogram for clinical usefulness. Decision curve analysis (DCA) further illustrated the potential clinical value of the nomogram for treatment decision-making. Additionally, we established a comprehensive risk grouping system that effectively categorized patients into distinct prognostic groups based on their predicted outcomes.ConclusionA precise prognostic nomogram was developed for patients with CNS GCTs, utilizing seven independent prognostic factors. It demonstrated satisfactory performance and clinical usability, aiding clinicians in accurately estimating prognosis and guiding the treatment and long-term management of patients with CNS GCTs.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1630061/fullprimary central nervous system (CNS) germ cell tumors (GCTs)overall survival (OS)nomogramrisk grouping systemSurveillanceEpidemiology
spellingShingle Dunchen Yao
Baokui Ye
Hongli Zhang
Long Pan
Dongjie Yao
Xu Li
Chengcheng Guo
Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
Frontiers in Immunology
primary central nervous system (CNS) germ cell tumors (GCTs)
overall survival (OS)
nomogram
risk grouping system
Surveillance
Epidemiology
title Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
title_full Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
title_fullStr Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
title_full_unstemmed Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
title_short Development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
title_sort development and validation of a nomogram for predicting overall survival in patients with primary central nervous system germ cell tumors
topic primary central nervous system (CNS) germ cell tumors (GCTs)
overall survival (OS)
nomogram
risk grouping system
Surveillance
Epidemiology
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1630061/full
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