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EAU 2026 Clinical Stage I NSGCT LVI Risk Group
Clinical Context & Background
This compatibility route is source-locked to the EAU 2026 clinical Stage I nonseminomatous germ cell tumor (NSGCT) risk grouping. After strict applicability checks, absent lymphovascular invasion (LVI) maps to the EAU low-risk group and present LVI maps to the EAU high-risk group.
The retired page identity claimed an MSK Stage I nomogram using -3.44 + 1.43(LVI) + 0.02(embryonal carcinoma percentage). No cited source supports that equation or identity. The current Memorial Sloan Kettering testicular nomogram instead addresses residual pathology after first-line chemotherapy for metastatic NSGCT, a different population and endpoint. This route does not calculate or convert that model.
Use only for a postpubertal male with a primary testicular NSGCT or mixed germ-cell tumor containing nonseminoma, completed radical inguinal orchiectomy, final orchiectomy pathology, confirmed clinical Stage I disease, normal or normalized postorchiectomy markers, complete staging showing no nodal or distant disease, and assessment before adjuvant management. Pure seminoma, pure postpubertal teratoma, extragonadal disease, Stage IS or Stage II/III, incomplete staging, prior therapy or relapse, biopsy-only pathology, somatic-type malignancy, and indeterminate LVI are not assigned a group.
Embryonal carcinoma percentage is not requested because it never changes this LVI-only group and no 50% threshold is applied. The output is a source-defined relapse-risk stratum, not an occult-node probability, individualized relapse estimate, surveillance or treatment recommendation, or substitute for multidisciplinary interpretation.
Formula Logic
After strict source-population validation: LVI absent = EAU 2026 low-risk group; LVI present = EAU 2026 high-risk group. Embryonal carcinoma percentage does not alter the group.Reference Data
| LVI in final orchiectomy report | EAU 2026 group | Interpretation boundary |
|---|---|---|
| Absent | Low-risk group | Source-defined relapse-risk stratum only |
| Present | High-risk group | Source-defined relapse-risk stratum only |
| Indeterminate | No group | Requires resolved final pathology |
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls across LVI absent, present, and indeterminate branches.
- The two source-defined risk groups and the intentional incomplete-assessment disposition rendered as expected.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/mskcc-nsgct-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route load.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/mskcc-nsgct.json.
: Input workflow simplified and revalidated
- Reduced the public form to result-, branch-, unit-, and applicability-changing inputs; removed or consolidated non-scoring, administrative, and duplicate questions.
- Preserved the verified calculation or report-interpretation logic, thresholds, model version, component logic, and supported result pathways behind strict deterministic adapters.
- Passed the calculator-specific regression audit, adapter-parity and malformed-input checks, the 144-calculator input-quality audit, and the 43-calculator entry-burden audit.
: Unsupported identity found
- The prior route claimed an MSK Stage I NSGCT equation that could not be supported by the cited literature or current MSK nomogram.
- The current MSK testicular nomogram concerns residual pathology after chemotherapy for metastatic NSGCT and is not calculated here.
: Reframed to EAU 2026
- Preserved the permanent route while changing the visible identity to the EAU 2026 clinical Stage I NSGCT LVI risk group.
- Limited the output to the EAU low-risk and high-risk strata defined by absent versus present LVI.
: Strict LVI and applicability contract added
- Added an exact immutable twelve-own-key contract covering postpubertal testicular NSGCT histology, orchiectomy pathology, clinical stage, markers, imaging, timing, somatic-type malignancy, LVI, and optional embryonal percentage.
- Malformed, contradictory, incomplete, and outside-scope contexts now withhold a risk group.
: Probabilities and treatment guidance removed; full validation completed
- Removed the unsupported equation, occult-node and individualized relapse probabilities, and surveillance, chemotherapy, or RPLND directives.
- 768/768 independent deterministic assertions passed. This is software implementation verification against the locked public definitions, not prospective or independent clinical validation.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
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Frequently Asked Questions
Is this an MSK nomogram?
No. The permanent compatibility route is preserved, but the unsupported MSK Stage I identity and equation were retired. The currently public MSK testicular nomogram concerns residual pathology after chemotherapy for metastatic NSGCT, not this Stage I LVI grouping.
Does embryonal carcinoma percentage alter the EAU 2026 group?
No. It is not requested because this implementation uses LVI alone: absent is low risk and present is high risk. It does not apply a 50% embryonal carcinoma threshold.
Does the high-risk group prescribe treatment?
No. The result is a source-defined relapse-risk stratum and does not estimate an individual probability or recommend surveillance, chemotherapy, or retroperitoneal lymph-node dissection.
Evidence-based oncology decision support. Verify with clinical guidelines.