Development of preoperative nomograms to predict the risk of overall and multifocal positive surgical margin after radical prostatectomy

Motivation: Preoperative prediction of the risk of positive surgical margin (PSM) is important for optimal treatment decision-making in patients with prostate cancer. Goal(s): To develop preoperative nomograms using risk factors based on clinicopathological and MRI for predicting the risk of PSM after radical prostatectomy. Approach: Preoperative clinicopathological factors and MRI-based features were recorded for analysis. The presence or absence of PSM (oPSM) at pathology and the multifocality of PSM (mPSM) were evaluated. Results: The nomogram for oPSM reached an AUC of 0.717 in development and 0.716 in internal verification. The AUC of the nomogram for mPSM was 0.790 in both development and internal verification. Impact: The proposed nomograms showed good performance and were feasible in predicting oPSM and mPSM. The evaluation of risk factors and the application of nomograms preoperatively might facilitate individualized management of prostate cancer.