预测侧特异性前列腺外延伸 (EPE) 对于选择进行保留神经根治性前列腺切除术 (RP) 的患者至关重要。包括磁共振成像 (MRI) 信息的多个列线图可用于预测侧面特异性 EPE。至关重要的是，通过外部验证评估这些列线图的准确性，以确保它们可以用于临床实践以支持医疗决策。2017 年至 2017 年接受机器人辅助 RP (RARP) 的前列腺癌 (PCa) 患者的数据回顾性收集了 2021 年四个欧洲三级转诊中心的数据。确定并外部验证了四个先前开发的用于预测侧面特异性 EPE 的列线图。评估了四个列线图的辨别力（曲线下面积 [AUC]）、校准和净效益。为了评估所有列线图中包含的 MRI 特征中最强的预测因子，我们使用多元回归分析和 Akaike 信息标准 (AIC) 评估了它们与侧面特异性 EPE 的关联。这项研究涉及 773 名患者，总共 1546 个前列腺叶。在 338 个 (22%) 叶中发现了 EPE。预测 EPE 的模型的 AUC 范围为 72.2% (95% CI 69.1-72.3%) (Wibmer) 到 75.5% (95% CI 72.5-78.5%) (Nyarangi-Dix)。各队列中 AUC 最高的列线图各不相同。 Soeterik、Nyarangi-Dix 和 Martini 列线图对 5% 到 30% 之间的临床最相关阈值进行了良好的校准。相比之下，Wibmer 列线图显示，对于高于 25% 的阈值，EPE 风险被大幅高估。与其他三个列线图相比，Nyarangi-Dix 列线图显示出 20% 至 30% 之间风险阈值的更高净收益。在所有 MRI 特征中，欧洲泌尿生殖放射学会评分和肿瘤包膜接触长度显示最高的 AUC 和最低的 AIC。Nyarangi-Dix、Martini 和 Soeterik 列线图可实现准确的 EPE 预测，因此适合支持医疗决策。 © 2023。作者获得施普林格自然有限公司的独家许可。

Prediction of side-specific extraprostatic extension (EPE) is crucial in selecting patients for nerve-sparing radical prostatectomy (RP). Multiple nomograms, which include magnetic resonance imaging (MRI) information, are available predict side-specific EPE. It is crucial that the accuracy of these nomograms is assessed with external validation to ensure they can be used in clinical practice to support medical decision-making.Data of prostate cancer (PCa) patients that underwent robot-assisted RP (RARP) from 2017 to 2021 at four European tertiary referral centers were collected retrospectively. Four previously developed nomograms for the prediction of side-specific EPE were identified and externally validated. Discrimination (area under the curve [AUC]), calibration and net benefit of four nomograms were assessed. To assess the strongest predictor among the MRI features included in all nomograms, we evaluated their association with side-specific EPE using multivariate regression analysis and Akaike Information Criterion (AIC).This study involved 773 patients with a total of 1546 prostate lobes. EPE was found in 338 (22%) lobes. The AUCs of the models predicting EPE ranged from 72.2% (95% CI 69.1-72.3%) (Wibmer) to 75.5% (95% CI 72.5-78.5%) (Nyarangi-Dix). The nomogram with the highest AUC varied across the cohorts. The Soeterik, Nyarangi-Dix, and Martini nomograms demonstrated fair to good calibration for clinically most relevant thresholds between 5 and 30%. In contrast, the Wibmer nomogram showed substantial overestimation of EPE risk for thresholds above 25%. The Nyarangi-Dix nomogram demonstrated a higher net benefit for risk thresholds between 20 and 30% when compared to the other three nomograms. Of all MRI features, the European Society of Urogenital Radiology score and tumor capsule contact length showed the highest AUCs and lowest AIC.The Nyarangi-Dix, Martini and Soeterik nomograms resulted in accurate EPE prediction and are therefore suitable to support medical decision-making.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.