Mazzone E, Gandaglia G, Ploussard G, et al. - Researchers established and externally validated four novel categories based on clinical and radiological parameters to prognosticate early biochemical recurrence (BCR). Compared with available tools, this novel classification demonstrates higher accuracy.

• Between 2014 and 2020, a retrospective multicenter cohort study was performed across seven academic international referral centers.

• They distinguished a total of 2,565 patients treated with radical prostatectomy (RP) for prostate cancer (PCa).

• The study found that overall, 200 (8%), 1,834 (71%), and 531 (21%) had low-, intermediate-, and high-risk disease according to the European Association of Urology (EAU) risk groups.

• As per the findings, 84% was the 3-yr overall BCR-free survival rate.

• There were no differences in the 3-yr BCR-free survival between EAU low- and intermediate-risk groups (88% vs 87%; p = 0.1).

• It was shown that the novel nomogram depicted optimal discrimination at external validation (c-index 78%).

• They further distinguished four new risk categories based on the predictors included in the Cox-based nomogram.

• Higher accuracy in predicting early BCR was observed by this new risk classification (c-index 70%) than the EAU, CAPRA, and STAR-CAP risk classifications (c-index 64%, 63%, and 67%, respectively).