本研究旨在评估从用于检测病理学囊外扩展 (pECE) 的预测模型得出的协变量对机器人辅助根治性前列腺切除术 (RARP) 后 4 年内生化无复发生存率 (BCRFS) 的影响。回顾性数据分析是该研究于 2015 年至 2022 年间在单一中心进行。考虑的变量包括前列腺特异性抗原 (PSA) 水平、患者年龄、前列腺体积、MRI 语义特征和分级组 (GG)。我们还评估了 pECE 和阳性手术切缘对 BCRFS 的影响。为了实现这些目标，我们使用了 Kaplan-Meier 生存函数和多变量 Cox 回归模型。此外，我们还分析了低/中风险患者 BCR（生化复发）的 MRI 特征。总共纳入了 177 名 RARP 后随访超过 6 个月的参与者。根治性前列腺切除术后 1 年、2 年和 4 年 BCR 风险分别为 5%、13% 和 21%。生存分析的非参数方法显示不良 MRI 特征，例如 MRI 上的宏观 ECE (mECE )、包膜破裂、肿瘤包膜接触长度高 (TCCL)、GG ≥ 4、手术切缘阳性 (PSM) 和 pECE病理学是 BCR 的危险因素。在低/中风险患者（pECE-和 GG < 4）中，不良 MRI 特征的存在已被证明会增加 BCR 的风险。该研究强调了结合预测 MRI 特征对于术前检测囊外扩张的重要性影响早期结果和临床决策； mECE、TCCL、包膜破裂和基于术前活检的 GG ≥ 4 是早期 BCR 的独立预后因素。 MRI 上存在的不良特征可以帮助识别低/中风险患者，这些患者将受益于更密切的监测。

This study aimed to assess the impact of the covariates derived from a predictive model for detecting extracapsular extension on pathology (pECE+) on biochemical recurrence-free survival (BCRFS) within 4 years after robotic-assisted radical prostatectomy (RARP).Retrospective data analysis was conducted from a single center between 2015 and 2022. Variables under consideration included prostate-specific antigen (PSA) levels, patient age, prostate volume, MRI semantic features, and Grade Group (GG). We also assessed the influence of pECE+ and positive surgical margins on BCRFS. To attain these goals, we used the Kaplan-Meier survival function and the multivariable Cox regression model. Additionally, we analyzed the MRI features on BCR (biochemical recurrence) in low/intermediate risk patients.A total of 177 participants with a follow-up exceeding 6 months post-RARP were included. The 1-year, 2-year, and 4-year risks of BCR after radical prostatectomy were 5%, 13%, and 21%, respectively. The non-parametric approach for the survival analysis showed that adverse MRI features such as macroscopic ECE on MRI (mECE+), capsular disruption, high tumor capsular contact length (TCCL), GG ≥ 4, positive surgical margins (PSM), and pECE+ on pathology were risk factors for BCR. In low/intermediate-risk patients (pECE- and GG < 4), the presence of adverse MRI features has been shown to increase the risk of BCR.The study highlights the importance of incorporating predictive MRI features for detecting extracapsular extension pre-surgery in influencing early outcomes and clinical decision making; mECE+, TCCL, capsular disruption, and GG ≥ 4 based on pre-surgical biopsy were independent prognostic factors for early BCR. The presence of adverse features on MRI can assist in identifying low/intermediate-risk patients who will benefit from closer monitoring.