Abstract
Purpose
Primary testicular diffuse large B-cell lymphoma (PT-DLBCL) is a relatively rare urological tumor with a high degree of malignancy and a poor prognosis. This study aimed to investigate the prognostic risk factors for survival of patients with PT-DLBCL, and then to construct a predictive model and verify its reliability.
Methods
First, we selected subjects from the SEER database (2000–2018) and analyzed the survival of PT-DLBCL patients by Kaplan–Meier test. Then, we analyzed prognostic factors by Cox regression. Finally, the data from the training cohort were used to construct a prediction model and represented with a nomogram. We evaluated the nomogram using the consistency index (C-index), decision curve analysis (DCA), and the area under the subject operating characteristic curve (ROC). In addition, calibration curves were plotted to assess the agreement between the column plot model and the actual model.
Results
We identified five independent risk factors for patient prognosis affecting OS and CSS in patients with PT-DLBCL by univariate and multivariate analysis, including age, transversality, Ann Arbor staging, chemotherapy, and radiotherapy. According to the above factors, we constructed prognostic nomograms, and found that age contributed the most to the survival of patients with PT-DLBCL. The C-indexes for the nomogram of OS and CSS in the training cohort were 0.758 (0.716–0.799) and 0.763 (0.714–0.812), and in the validation cohort were OS and CSS 0.756 (0.697–0.815) and 0.748 (0.679–0.817).
Conclusion
We produced the first nomogram of PT-DLBCL, and it can be used to evaluate the CSS and OS of patients to determine the prognosis of patients.
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Data availability
The data that support the findings of this study are available in the SEER database. These data were derived from the following resources available in the public domain: https://seer.cancer.gov/seerstat/.
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Acknowledgements
Thanks to all those who contributed to this research, The SEER database provides us with a free public resource.
Funding
This work was supported by the key research and development (R&D) projects of Gansu Province (Grant No. 17YF1FA126); Lanzhou Science and Technology Bureau Medical and Health Project (Grant No. 2021-90); and CuiYing Science and Technology Innovation plan project of Lanzhou University Second Hospital (Grant No. CY2017-BJ05).
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Conception and design were done by PS and SY. Analysis and interpretation of data were done By SY. Drafting of the manuscript and statistical analysis was done by SY and BZ. Critical revision of the manuscript for important intellectual content was done by PS and WC.
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We selected the data from the SEER database, which is a public database and does not require ethical approval. We can find it from http://seer.cancer.gov/seerstat/.
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Yang, S., Chang, W., Zhang, B. et al. What factors are associated with the prognosis of primary testicular diffuse large B-cell lymphoma? A study based on the SEER database. J Cancer Res Clin Oncol 149, 10269–10278 (2023). https://doi.org/10.1007/s00432-023-04907-8
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DOI: https://doi.org/10.1007/s00432-023-04907-8