Development and validation of a survival nomogram in patients with primary testicular diffuse large B-cell lymphoma

Abstract

Objective We developed and validated a nomogram for overall survival (OS) and cancer-specific survival (CSS) prediction in patients with primary testicular diffuse large B-cell lymphoma (PT-DLBCL). Methods Patients diagnosed with PT-DLBCL were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors were analyzed to establish a nomogram of OS and CSS. Patients were reclassified into high- and low-risk groups; survival was compared using Kaplan–Meier curves and log-rank tests. Results We collected 1099 PT-DLBCL cases (2000–2019) from SEER and randomized into training (n = 771) and validation (n = 328) cohorts. In univariate and multivariate Cox regression analyses, five prognostic indicators (age, treatment modality, diagnosis year, Ann Arbor stage, laterality) were used to establish a nomogram of OS and CSS. The nomogram demonstrated excellent discrimination and calibration, with concordance indices in the training and validation cohorts of 0.702 (95% confidence interval [CI], 0.677–0.727) and 0.705 (95% CI 0.67–0.74) for OS and 0.694 (95% CI 0.663–0.725) and 0.680 (95% CI 0.63–0.72) for CSS. The calibration curve and ROC analysis indicated good predictive capability of the nomogram. Conclusions The constructed prognostic model showed good predictive value for PT-DLBCL to assist clinicians in developing individualized treatment strategies.

Synchronous Primary Testicular Tumor: a case report of diffuse large B-cell lymphoma

“…The immunohistochemical panel most commonly associated with diffuse large B-cell lymphoma are the proteins Bcl-2, (5) Bcl-6, (6) CD20, (7) Ki67, (8) and MUM-1, (9) as shown in Figure 2 & 3 below. Currently, the patient is in good general condition and is being followed-up as an outpatient, 6 months after treatment.…”

“…(10) Our patient was 63 years old and was diagnosed with PTL class II according to the Ann Arbor classification. (11) PTL classically presents as a painless, swollen and hard testis or testicular mass (bacterial epididymo-orchitis, primary testicular tumors, testicular infarction, and genitourinary tuberculosis should be considered in the differential diagnosis) without preference for either side or synchronous bilateral involvement in approximately 6-10%, (6) and asynchronous lesions in 30-35% of all cases. (3) In addition to imaging and laboratory tests, accurate characterization of the tumor requires spinal fluid analysis because the central nervous system is affected in approximately 40% of cases.…”