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MSKCC Stage I NSGCT Nomogram

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Clinical Context & Background

This tool uses the MSKCC criteria (Lymphovascular Invasion and Predominance of Embryonal Carcinoma) to predict the risk of occult nodal metastases in Clinical Stage I Non-Seminomatous Germ Cell Tumor (NSGCT). It helps decide between Active Surveillance vs. RPLND or Adjuvant Chemotherapy.
Primary Source EvidenceSteyerberg EW, Habbema JD, Keizer HJ, et al. Prediction of occult retroperitoneal metastases in clinical stage I nonseminoma: construction and validation of a model based on six studies. J Clin Oncol. 2006;24(26):4236-4242.
Formula Logic
Risk based on LVI status and % Embryonal Carcinoma.

Reference Data

LVIEmbryonal %Occult Metastasis Risk
NegativeLower %Low (~10-15%)
PositiveHigher %High (~50%)

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