scholarly journals Combined use of multimodal techniques for the resection of glioblastoma involving corpus callosum

2021 ◽  
Author(s):  
Meng Cui ◽  
Hewen Chen ◽  
Guochen Sun ◽  
Jialin Liu ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Corpus Callosum ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Conventional Approach ◽  
Conventional Group ◽  
Motor Deficits ◽  
Patient Demographics ◽  
Combined Use ◽  
Postoperative Radiochemotherapy

Abstract Purpose To compare the multimodal techniques (including neuronavigation, intraoperative MRI [iMRI], and neuromonitoring [IONM]) and conventional approach (only guided by neuronavigation) in removing glioblastoma (GBM) with corpus callosum (CC) involvement (ccGBM), their effectiveness and safety were analyzed and compared. Methods Electronic medical records were retrospectively reviewed for ccGBM cases treated in our hospital between January 2016 and July 2020. Patient demographics, tumor characteristics, clinical outcomes, extent of resection (EOR), progression-free survival (PFS), and overall survival (OS) were obtained and compared between the multimodal group (used multimodal techniques) and the conventional group (only used neuronavigation). Both groups only included patients that had maximal safe resection (not biopsy). Postoperative radiochemotherapy was also performed or not. Univariate and multivariate analyses were performed to identify significant prognostic factors and optimal EOR threshold. Results Finally 56 cases of the multimodal group and 21 cases of the conventional group were included. The multimodal group achieved a higher median EOR (100% versus 96.1%, P = 0.036) and gross total resection rate (60.7% versus 33.3%, P = 0.032) and a lower rate of permanent motor deficits (5.4% versus 23.8%, P = 0.052) than the conventional approach. The multimodal group had the longer median PFS (10.9 versus 7.0 months, P = 0.023) and OS (16.1 versus 11.6 months, P = 0.044) than the conventional group. Postoperative language and cognitive function were similar between the two groups. In multivariate analysis, a higher EOR, radiotherapy, and longer cycles of temozolomide chemotherapy were positive prognostic factors for survival of ccGBM. An optimal EOR threshold of 92% was found to significantly benefit the PFS (HR = 0.51, P = 0.036) and OS (HR = 0.49, P = 0.025) of ccGBM. Conclusion Combined use of multimodal techniques can optimize the safe removal of ccGBM. Aggressive resection of EOR > 92% using multimodal techniques combined with postoperative radiochemotherapy should be suggested for ccGBM.

Metastasis Stage, Adjuvant Treatment, and Residual Tumor Are Prognostic Factors for Medulloblastoma in Children: Conclusions From the Children's Cancer Group 921 Randomized Phase III Study

1999 ◽  
Vol 17 (3) ◽  
pp. 832-832 ◽  
Author(s):  
Paul M. Zeltzer ◽  
James M. Boyett ◽  
Jonathan L. Finlay ◽  
A. Lel Albright ◽  
Lucy B. Rorke ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Extent Of Resection ◽  
Phase Iii ◽  
Tumor Spread ◽  
Prognostic Effect ◽  
Cancer Group ◽  
Before And After ◽  
Phase Iii Study

PURPOSE: From 1986 to 1992, “eight-drugs-in-one-day” (8-in-1) chemotherapy both before and after radiation therapy (XRT) (54 Gy tumor/36 Gy neuraxis) was compared with vincristine, lomustine (CCNU), and prednisone (VCP) after XRT in children with untreated, high-stage medulloblastoma (MB). PATIENTS AND METHODS: Two hundred three eligible patients with an institutional diagnosis of MB were stratified by local invasion and metastatic stage (Chang T/M) and randomized to therapy. Median time at risk from study entry was 7.0 years. RESULTS: Survival and progression-free survival (PFS) ± SE at 7 years were 55% ± 5% and 54% ± 5%, respectively. VCP was superior to 8-in-1 chemotherapy, with 5-year PFS rates of 63% ± 5% versus 45% ± 5%, respectively (P = .006). Upon central neuropathology review, 188 patients were confirmed as having MB and were the subjects for analyses of prognostic factors. Children aged 1.5 to younger than 3 years had inferior 5-year estimates of PFS, compared with children 3 years old or older (P = .0014; 32% ± 10% v 58% ± 4%, respectively). For MB patients 3 years of age or older, the prognostic effect of tumor spread (M0 v M1 v M2+) on PFS was powerful (P = .0006); 5-year PFS rates were 70% ± 5%, 57% ± 10%, and 40% ± 8%, respectively. PFS distributions at 5 years for patients with M0 tumors with less than 1.5 cm2 of residual tumor, versus ≥ 1.5 cm2 of residual tumor by scan, were significantly different (P = .023; 78% ± 6% v 54% ± 11%, respectively). CONCLUSION: VCP plus XRT is a superior adjuvant combination compared with 8-in-1 chemotherapy plus XRT. For patients with M0 tumors, residual tumor bulk (not extent of resection) is a predictor for PFS. Patients with M0 tumors, ≥ 3 years with ≤ 1.5 cm2 residual tumor, had a 78% ± 6% 5-year PFS rate. Children younger than 3 years old who received a reduced XRT dosage had the lowest survival rate.

scholarly journals 5-Aminolevulinic Acid guided resection improves the overall survival of patients with Glioblastoma - A comparative cohort study of 343 patients

2021 ◽  
Author(s):  
Asfand Baig Mirza ◽  
Ioannis Christodoulides ◽  
Jose Pedro Lavrador ◽  
Anastasios Giamouriadis ◽  
Amisha Vastani ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Neurological Deficit ◽  
Aminolevulinic Acid ◽  
Performance Status ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Motor Deficits ◽  
Focal Neurological Deficit ◽  
Guided Surgery

Abstract Background 5-Aminolevulic Acid guided surgery (5-ALA-GS) improves the extent of resection and progression free survival in patients with glioblastoma multiforme (GBM). Methods Single-center retrospective cohort study of adult patients with GBM who had surgical resection between 2013 and 2019, 5-ALA guided versus a non 5-ALA cohort. Primary outcome was the overall survival (OS). Secondary outcomes were extent of resection (EoR), performance status (PS), and new focal neurological deficit. Results 343 patients were included: 253 patients in 5-ALA-GS Group and 90 patients in the non-5-ALA-GS Group. The OS (17.47 versus 10.63 months, p<0.0001), post-operative PS (p<0.0001), PS at 6 months (p=0.002), new focal neurological deficit (23.3% versus 44.9%, p<0.0001) and radiological EoR (gross total resection (GTR) - 47.4% versus 22.9%, p< 0.0001) were significantly better in the 5-ALA-GS Group compared to non-5-ALA-GS Group. In multivariate analysis, use of 5-ALA (p=0.003) and MGMT promoter methylation (p=0.001) were significantly related with a better OS. In patients with radiological GTR, OS was also significantly better (p<0.0001) in the 5-ALA-GS Group compared to the non-5-ALA-GS Group. Conclusions 5-ALA guided surgery is associated with a significant improvement in the OS, PS after surgery and at six months, larger EoR, and fewer new motor deficits in patients with GBM.

Prognostic factors and outcome of atypical and anaplastic meningioma with and without radiation.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2083-2083
Author(s):  
Hannah Yoon ◽  
Irene B. Helenowski ◽  
Karthikeyan Perumal ◽  
MaryAnne H. Marymont ◽  
James Chandler ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
External Beam Radiation ◽  
Subtotal Resection ◽  
Beam Radiation ◽  
Brain Invasion ◽  
Simpson Grade

2083 Background: We evaluated outcome and prognostic factors for high grade meningioma (G2-3) and the role of early post-operative radiotherapy (RT). Methods: From 2000 to 2010, 136 patients were diagnosed with G2-3 meningioma at Northwestern: 124 with atypical (G2) and 12 with anaplastic (G3) meningioma. All were treated with or without RT after initial or subsequent resection. The primary endpoint was progression-free survival (PFS). Results: 21 patients received adjuvant RT, and 115 did not. Median PFS for G2 with and without RT was 68 vs.89 mos. Median PFS for G3 with and without RT was not reached=nr (mean 5) vs.60 mos (mean 35). Median PFS for Simpson G1-3 with and without RT was 18 vs.96 mos. Median PFS for Simpson G4 with and without RT was nr (mean 55) vs.59 mos (mean 44). For median follow-up of 33 mos for Simpson G1-3 and 29 mos for G4, recurrence rate for Simpson G1-3 with and without RT was 40 vs.6%, and for Simpson G4 with and without RT, 9 vs.31%. 3-yr OS for G2 with and without RT was 93 vs.94%. 3-yr OS for G3 with and without RT was 80 vs.80%. In multivariate analysis, G3 histology and Simpson grade were predictive for relapse, while brain invasion, mitoses, adjuvant RT, and location of tumor were not. For those who received adjuvant RT, mean dose of external beam radiation (EBRT) in 2 patients was 58 Gy, while mean dose of stereotactic radiosurgery (SRS) in 15 patients was 15 Gy. 51% EBRT patients recurred, while 22% SRS patients recurred (p = 0.45). Median PFS with EBRT was 43 vs.51 mos for SRS (p = 0.34). Patients were maldistributed between the with and without RT arms in terms of brain invasion, extent of resection, and G3 histology. Conclusions: Patients who received RT had lower PFS compared to those who did not; survival was comparable. This may be due to inherent selection bias for patients with more aggressive disease getting adjuvant RT. Our study may be underpowered to determine the true role of RT in G2-3 meningioma. Patients with subtotal resection, Simpson G4, who received RT had fewer recurrences and higher PFS compared to those who did not. 3-yr OS was equivalent in both G2 and G3 tumors with and without RT. G3 histology and Simpson grade were predictive for relapse while brain invasion, mitoses, adjuvant RT, and location of tumor were not.

scholarly journals Efficacy and Safety of Lenvatinib Therapy for Unresectable Hepatocellular Carcinoma in a Real-World Practice in Korea

Liver Cancer ◽  
2021 ◽  
pp. 1-11
Author(s):  
Myung Ji Goh ◽  
Joo Hyun Oh ◽  
Yewan Park ◽  
Jihye Kim ◽  
Wonseok Kang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Disease Progression ◽  
Real World ◽  
Medical Center ◽  
Objective Response ◽  
Progression Free Survival ◽  
Efficacy And Safety ◽  
Eligibility Criteria ◽  
Unresectable Hepatocellular Carcinoma

<b><i>Background:</i></b> Lenvatinib has been recently approved as a first-line treatment option for patients with unresectable hepatocellular carcinoma (HCC) in Korea. We aimed to study the efficacy and safety of lenvatinib therapy in a real-world practice and to find prognostic factors related to survival and disease progression. <b><i>Methods:</i></b> A hospital-based retrospective study was conducted on 111 consecutive patients who had unresectable HCC and were treated with lenvatinib at Samsung Medical Center from October 2018 to March 2020. Efficacy was determined using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria in 111 patients who completed 1st tumor assessment. Safety was evaluated in 116 HCC patients including 5 patients who discontinued lenvatinib due to adverse events (AEs) before 1st tumor assessment using Common Terminology Criteria for AEs version 5.0. <b><i>Results:</i></b> A total of 111 patients with a median age of 59 years were analyzed during a median follow-up duration of 6.2 (4.4–9.0) months. The Kaplan-Meier estimate of overall survival was 10.5 months, and the median progression-free survival was 6.2 months. Based on mRECIST criteria, the objective response rate was 18.9% and disease control rate was 75.7%. AEs developed in 86/116 (74.1%) patients, and grade ≥3 AEs developed in 16/116 (13.8%) patients. Diarrhea, hand-foot skin rash, abdominal pain, hypertension, and anorexia were identified as the AEs with the highest frequencies of any grade. REFLECT eligibility criteria including tumor extent ≥50% liver occupation or inadequate bone marrow function and occurrence of anorexia were prognostic factors for survival, and occurrence of diarrhea was a favorable factor for disease progression. <b><i>Conclusion:</i></b> Lenvatinib therapy showed a favorable efficacy and safety in a real-world practice. The REFLECT eligibility criteria and specific AEs could be one of the prognostic markers.

scholarly journals Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Atsushi Hiraoka ◽  
Takashi Kumada ◽  
Toshifumi Tada ◽  
Joji Tani ◽  
Kazuya Kariyama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Liver Disease ◽  
Hazard Analysis ◽  
Progression Free Survival ◽  
Significant Prognostic Factor ◽  
Disease Etiology ◽  
Alcoholic Fatty Liver ◽  
Free Survival ◽  
Significant Difference

AbstractIt was recently reported that hepatocellular carcinoma (HCC) patients with non-alcoholic steatohepatitis (NASH) are not responsive to immune-checkpoint inhibitor (ICI) treatment. The present study aimed to evaluate the therapeutic efficacy of lenvatinib in patients with non-alcoholic fatty liver disease (NAFLD)/NASH-related unresectable-HCC (u-HCC). Five hundred thirty u-HCC patients with Child–Pugh A were enrolled, and divided into the NAFLD/NASH (n = 103) and Viral/Alcohol (n = 427) groups. Clinical features were compared in a retrospective manner. Progression-free survival (PFS) was better in the NAFLD/NASH than the Viral/Alcohol group (median 9.3 vs. 7.5 months, P = 0.012), while there was no significant difference in overall survival (OS) (20.5 vs. 16.9 months, P = 0.057). In Cox-hazard analysis of prognostic factors for PFS, elevated ALT (≥ 30 U/L) (HR 1.247, P = 0.029), modified ALBI grade 2b (HR 1.236, P = 0.047), elevated AFP (≥ 400 ng/mL) (HR 1.294, P = 0.014), and NAFLD/NASH etiology (HR 0.763, P = 0.036) were significant prognostic factors. NAFLD/NASH etiology was not a significant prognostic factor in Cox-hazard analysis for OS (HR0.758, P = 0.092), whereas AFP (≥ 400 ng/mL) (HR 1.402, P = 0.009), BCLC C stage (HR 1.297, P = 0.035), later line use (HR 0.737, P = 0.014), and modified ALBI grade 2b (HR 1.875, P < 0.001) were significant. Lenvatinib can improve the prognosis of patients affected by u-HCC irrespective of HCC etiology or its line of treatment.

scholarly journals Image-Guided Multisession Radiosurgery of Skull Base Meningiomas

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3569
Author(s):  
Alfredo Conti ◽  
Antonio Pontoriero ◽  
Giuseppe Iatì ◽  
Salvatore M. Cardali ◽  
Anna Brogna ◽  
...  
Keyword(s):  
Skull Base ◽  
Stereotactic Radiosurgery ◽  
Cranial Nerves ◽  
Progression Free Survival ◽  
Motor Deficits ◽  
Intracranial Meningioma ◽  
Treatment Schedule ◽  
Fractionated Radiotherapy ◽  
Patient Reported ◽  
Skull Base Meningiomas

Background: The efficacy of single-session stereotactic radiosurgery (sSRS) for the treatment of intracranial meningioma is widely recognized. However, sSRS is not always feasible in cases of large tumors and those lying close to critically radiation-sensitive structures. When surgery is not recommended, multi-session stereotactic radiosurgery (mSRS) can be applied. Even so, the efficacy and best treatment schedule of mSRS are not yet established. The aim of this study is to validate the role of mSRS in the treatment of skull base meningiomas. Methods: A retrospective analysis of patients with skull base meningiomas treated with mSRS (two to five fractions) at the University of Messina, Italy, from 2008 to 2018, was conducted. Results: 156 patients met the inclusion criteria. The median follow-up period was 36.2 ± 29.3 months. Progression-free survival at 2-, 5-, and 10- years was 95%, 90%, and 80.8%, respectively. There were no new visual or motor deficits, nor cranial nerves impairments, excluding trigeminal neuralgia, which was reported by 5.7% of patients. One patient reported carotid occlusion and one developed brain edema. Conclusion: Multisession radiosurgery is an effective approach for skull base meningiomas. The long-term control is comparable to that obtained with conventionally-fractionated radiotherapy, while the toxicity rate is very limited.

scholarly journals EPID-26. CLINICAL AND HISTOLOGICAL CHARACTERIZATION OF PRIMARY CENTRAL NERVOUS SYSTEM SARCOMA IN PEDIATRICS. A SINGLE INSTITUTION EXPERIENCE IN A MIDDLE-INCOME COUNTRY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii84-ii84
Author(s):  
Edgar Cabrera ◽  
Nelson Aponte ◽  
Johnny Garcia ◽  
Fredy Salazar ◽  
Eric Bouffet ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pediatric Population ◽  
Progression Free Survival ◽  
Molecular Data ◽  
Middle Income ◽  
Patient Demographics ◽  
Time Period ◽  
Cell Architecture ◽  
Intracranial Lesions

Abstract INTRODUCTION Primary central nervous system (CNS) sarcomas are rare mesenchymal non-meningothelial tumors accounting for less than 0.2% of intracranial lesions. Diagnosis and management are challenging due to the current lack of substantive clinical, histological and molecular data. METHODS We retrospectively identified all patients with diagnosis of primary CNS sarcoma at the Hospital Fundación Pediatrico la Misericordia (HOMI) in Bogota, Colombia. We collected patient demographics, disease characteristics, and outcomes for analysis. RESULTS Between 2008 and 2020, twenty-four consecutive patients were diagnosed at the HOMI representing 6% of all CNS tumors diagnosed over the same time period. The median age at presentation was 9.48 years (range:1.6–13.4). The median time of symptoms prior to diagnosis was 2 weeks (0.1–24). The most common presentation was headache (21/24- 89%) and vomiting (19/24- 79%). The frontal lobe was involved in 63% of patients (15/24) and only one patient presented with a cerebellar lesion. Histologically, these tumors were characterized by a pleomorphic spindle cell architecture and high mitotic activity. All samples lacked immunoreactivity to GFAP, CD34, EMA, and S100 and all samples had strong nuclear immunopositivity for TLE-1; BCL-2 was reactive in eighteen cases. Gross total resection was attained in fifteen patients, most patients received focal radiation therapy and ICE chemotherapy. Progression-free survival at 12 and 24 months was 57% and 31% respectively. Overall survival was 77% at 12 months and 39% at 24 months. Thirteen patients relapsed, 11 presented with local failures, and 2 with intracranial recurrences outside of the radiation field. CONCLUSION Our study identifies TLE-1 as a diagnostic marker of primary CNS sarcoma, a highly malignant supratentorial tumor of childhood. Further molecular studies are urgently needed to elucidate the biology of this disease and the unusually high incidence observed in the Colombian pediatric population.

The Role of Surgery in IDH-Wild-Type Lower-Grade Gliomas: Threshold at a High Extent of Resection Should be Pursued

Neurosurgery ◽  
2021 ◽  
Author(s):  
Peng Wang ◽  
Chen Luo ◽  
Peng-jie Hong ◽  
Wen-ting Rui ◽  
Shuai Wu
Keyword(s):  
Cox Regression ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Lower Grade ◽  
Wild Type ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Lower Grade Glioma ◽  
Clinical Benefits

Abstract BACKGROUND While maximizing extent of resection (EOR) is associated with longer survival in lower-grade glioma (LGG) patients, the number of cases remains insufficient in determining a EOR threshold to elucidate the clinical benefits, especially in IDH-wild-type LGG patients. OBJECTIVE To identify the effects of EOR on the survival outcomes of IDH-wild-type LGG patients. METHODS IDH-wild-type LGG patients were retrospectively reviewed. The effect of EOR and other predictor variables on overall survival (OS) and progression-free survival (PFS) was analyzed using Cox regression models and the Kaplan-Meier method. RESULTS A total of 94 patients (median OS: 48.9 mo; median follow-up: 30.6 mo) were included in this study. In the multivariable Cox regression analysis, postoperative residual volume was associated with prolonged OS (HR = 2.238; 95% confidence interval [CI], 1.130-4.435; P = .021) and PFS (HR = 2.075; 95% CI, 1.113-3.869; P = .022). Thresholds at a minimum EOR of 97.0% or a maximum residue of 3.0 cm3 were necessary to impact OS positively. For the telomerase reverse transcriptase (TERT)p-wild-type group, such an association was absent. Significant differences in survival existed between the TERTp-wild-type and mutant patients who underwent relatively incomplete resections (residual ≥2.0 cm3 + TERTp wild type: median OS of 62.6 mo [95% CI: 39.7-85.5 mo]; residual ≥2.0 cm3 + TERTp mutant: median OS of 20.0 mo [95% CI:14.6-25.4 mo]). CONCLUSION Our results support the core role of maximal safe resection in the treatment of IDH-wild-type LGGs, especially for IDH-wild-type + TERTp-mutant LGGs. Importantly, the survival benefits of surgery could only be elucidated at a high EOR cut-off point.

Clinicopathological Prognostic Factors Influencing Survival Outcomes of Vulvar Cancer

2021 ◽  
Author(s):  
Monwanee Muangchang ◽  
Prapaporn Suprasert ◽  
Surapan Khunamornpong
Keyword(s):  
Prognostic Factors ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Tumor Diameter ◽  
Large Tumor ◽  
Node Positive ◽  
Kaplan Meier ◽  
Postmenopausal Status ◽  
Vulva Cancer ◽  
Tumor Area

Abstract Backgroud: Squamous cell carcinoma (SCCA) is the most common vulva cancer. This study purpose to evaluate the clinicopathological prognostic factors for survival outcomes of this disease after treated with surgery. Methods: All SCCA vulva cancer patients who underwent surgery between January 2006 and December 2017 were reviewed. The clinicopathological factors were analyzed to identify the prognostic factors for the progression-free survival (PFS) and overall survival (OS) using the Kaplan- Meier method and Cox-Proportional Hazard model.Results: One hundred twenty-five patients were recruited with a median age of 57 years. The recurrence rate was 35.2%. Patients with recurrence revealed a significant poorer five-year OS rate than those who did not recur (23.7% vs. 79.4%, P < 0.001). About 58.1% of palpable groin nodes revealed metastasis. The independent poor prognostic factors for PFS were groin node-positive and a tumor diameter more than 25 mm. whereas postmenopausal status, preoperative tumor area more than 11 cm2, and groin node enlargement were independent poor prognostic factors for OS. Conclusion: Groin node-positive and tumor diameter longer than 25 mm. were independent poor prognostic factors for PFS whereas postmenopausal status, large tumor area than 11 cm2, and enlargement of groin nodes were independent poor prognostic factors for OS. Patients with these factors should be closely followed.

Construction and Validation of a Nomogram for Predicting Progression-Free Survival in Patients with Early-Stage Testicular Germ Cell Tumor

2021 ◽  
Vol 16 ◽  
Author(s):  
Jin-Guo Chen ◽  
Jing-Quan Wang ◽  
Tian-Wen Peng ◽  
Zhe-Sheng Chen ◽  
Shan-Chao Zhao
Keyword(s):  
Prognostic Factors ◽  
Validation Cohort ◽  
Early Stage ◽  
Predictive Ability ◽  
Testicular Germ Cell Tumor ◽  
Progression Free Survival ◽  
Cell Tumor ◽  
Testicular Germ Cell ◽  
Free Survival ◽  
Training Cohort

Background: Testicular Germ Cell Tumor (TGCT) is the most common malignant tumor in young men, but there is a lack of prediction model to evaluate 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 were 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 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.

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