The Prognostic Role of the Naples Prognostic Score in Testicular Germ Cell Tumors: A Retrospective Analysis.

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-09-13 DOI:10.1159/000548383

Hakan Tekinaslan, Osman Köse, Serkan Ozcan, Sacit Nuri Görgel, Yigit Akin

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Abstract

Introduction: The aim of this study was to evaluate the prognostic significance of the Naples Prognostic Score (NPS) in testicular germ cell tumors (TGCT), with a focus on its association with tumor stage, histological subtype, and survival outcomes.

Methods: In this retrospective study, 133 patients with TGCT treated at a single tertiary center between 2015 and 2023 were evaluated. The NPS was calculated for each patient based on pre-treatment albumin, cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Patients were stratified into low (0-2) and high (3-4) NPS groups. Clinicopathological characteristics were compared between NPS groups. Overall survival was analyzed using Kaplan-Meier estimates with log-rank tests, and Cox proportional hazards regression was performed to identify independent prognostic factors.

Results: Patients with high NPS were significantly younger on average and more likely to have non-seminomatous histology, advanced clinical stage, elevated tumor markers, and metastatic disease compared to those with low NPS (all p < 0.01). Overall survival was markedly worse in the high NPS group (p < 0.005). On multivariate analysis, NPS emerged as an independent predictor of poorer overall survival alongside clinical stage (hazard ratio for high NPS ∼ 8.4, p = 0.018).

Conclusion: The NPS is a significant prognostic indicator in TGCT. A high NPS is associated with aggressive disease features and inferior survival outcomes, remaining an independent prognostic factor when controlling for stage. Incorporating NPS into clinical risk stratification may help identify TGCT patients at higher risk of treatment failure, though prospective studies are warranted to validate its utility.

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那不勒斯预后评分在睾丸生殖细胞肿瘤中的预后作用：回顾性分析。

目的：评价那不勒斯预后评分（Naples prognostic Score， NPS）在睾丸生殖细胞肿瘤（TGCT）患者中的预后意义，包括其与肿瘤分期、组织学亚型和生存结局的关系。方法：在这项回顾性研究中，评估了2015年至2023年间在单一三级中心接受TGCT治疗的133例患者。根据治疗前白蛋白、胆固醇、中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值（LMR）计算每位患者的NPS。将患者分为低NPS组（0-2）和高NPS组（3-4）。比较NPS组间的临床病理特征。使用Kaplan-Meier估计和log-rank检验分析总生存率，并使用Cox比例风险回归来确定独立预后因素。结果：与低NPS患者相比，高NPS患者的平均年龄明显更年轻，非半瘤性组织学、临床分期、肿瘤标志物升高和转移性疾病的可能性更大（均p < 0.01）。高NPS组总生存率明显较差（p < 0.005）。在多变量分析中，NPS成为较差的总生存期和临床分期的独立预测因子（高NPS的风险比≈8.4,p = 0.018）。结论：NPS是TGCT的重要预后指标。高NPS与侵袭性疾病特征和较差的生存结果相关，在控制分期时仍然是一个独立的预后因素。将NPS纳入临床风险分层可能有助于识别治疗失败风险较高的TGCT患者，尽管需要前瞻性研究来验证其效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.