Side-specific, mpMRI-based nomogram for the prediction of extracapsular extension of prostate cancer
Development and internal validation of a side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer
Research authors: Alberto Martini, Akriti Gupta, Sara C. Lewis, Shivaram Cumarasamy, Kenneth G. Haines III, Alberto Briganti, Francesco Montorsi, Ashutosh K. Tewari
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Prostate Cancer
  • Prostate Specific Antigen
  • Magnetic Resonance Imaging
  • Model type
    Logistic regression (Calculation)
    No Formula defined yet
    Condition Formula

    Additional information

    Data from 589 patients who underwent robot-assisted radical prostatectomy between February 2014 and October 2015 were retrospectively collected. Patients who underwent neoadjuvant hormonal therapy or radiation therapy were excluded. Patients who underwent mpMRI before surgery were included. All patients received a standard systematic (12-core) transrectal biopsy prior to surgery. When mpMRI was performed prior to biopsy, two to four extra targeted biopsy cores were obtained in addition to the standard 12 cores; this was done only when the mpMRI identified a lesion(s)

    Study Population

    Total population size: 561
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name LL Q1 Median Q3 UL Unit
    Age at surgery 56 62 67 years
    preoperative PSA 4.3 5.5 7.9 ng/ml
    Maximum % core involvement 20 50 80 %

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Clinical stage T1c 372
    T2a 103
    T2b 46
    T2c 31
    T3a-b 9
    Biopsy Gleason Grade Group 1 169
    2 220
    3 94
    4 56
    5 22
    Pathological stage T2 420
    T3a 90
    T3b 50
    Tx 1
    Pathological Gleason grade group 1 75
    2 333
    3 111
    4 11
    5 30
    Unknown 1
    Surgical margins status Negative 525
    Positive 30

    The risk for side-specific extracapsular extension is:

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    The risk for side-specific extracapsular extension is:

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    Outcome stratification

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    Conditional information

    Result interpretation

    The calculated probability serves as a tool for planning nerve-sparing radical prostatectomy and may lead to a reduction in positive surgical margins in future patients. 

    The authors of the model propose four different grades of nerve sparing prostatectomy based upon the probability of side-specific extracapsular extension according to this model. See the conditional information above for detailed info on the Nerve Sparing approaches.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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