ArticleEuropean urology2025
Development and Validation of a Multimodal Artificial Intelligence-derived Digital Pathology-based Biomarker Predicting Metastasis Among Patients with Biochemical Recurrence After Radical Prostatectomy in NRG/RTOG Trials.
Article in European urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Early Identification and Management of Biochemical Recurrence Following Radical Prostatectomy.Annals of surgical oncology · 2026Review
- A comparison of efficacy and prognosis between RC48 combined immunotherapy and gemcitabine-cisplatin combined immunotherapy in bladder-preserving multimodal therapy for muscle-invasive bladder cancer.International urology and nephrology · 2026Article
- Article
- AI-driven precision diagnosis and treatment of prostate cancer: a narrative review.Frontiers in oncology · 2026Review
- Review
- Discordant molecular biomarkers in unfavorable intermediate-risk localized prostate cancer.CA: a cancer journal for cliniciansArticle
Corrections and comments
- Erratum issued
Authors and funding
27 authors.
Funding
Abstract
BACKGROUND AND
objectiveBiochemical recurrence (BCR) after radical prostatectomy (RP) is a heterogeneous disease state in prostate cancer with multiple treatment options. Improved risk stratification could enable more personalized decision-making. We developed and validated a digital pathology-based multimodal artificial intelligence (MMAI) model to predict outcomes in post-RP BCR patients undergoing salvage therapy.
methodsAn MMAI model was trained to predict distant metastasis (DM) using prostate histopathology image features and clinical variables (pathologic grade group, pathologic T stage, prostate-specific antigen level before salvage radiotherapy [SRT], age, and surgical margin). The locked model was validated in 533 patients from NRG/RTOG 9601 and 0534 treated with SRT ± hormone therapy (HT), using Cox regression and time-dependent area under the receiver operating characteristic curve. KEY FINDINGS AND LIMITATIONS: With a median follow-up of 9.3 yrs, MMAI score was significantly associated with DM (subdistribution hazard ratio = 2.17 per standard deviation [95% confidence interval 1.65-2.85]; p < 0.001) and remained independently prognostic after adjusting for clinical variables and treatment. The 10-yr time-dependent area under the receiver operating characteristic curve for MMAI was 0.74 compared with 0.68 for a clinical nomogram. Binary risk categorization demonstrated higher 10-yr DM incidence in the MMAI high-risk (25%) than in the low-risk (8.8%) group. The absolute reduction in 10-yr DM incidence with HT plus SRT versus SRT alone was 21% in the high-risk group versus 2.5% in the low-risk group. Limitations include the use of archived trial cohorts. CONCLUSIONS AND CLINICAL IMPLICATIONS: The post-RP MMAI model provides individualized risk estimates after SRT ± HT and may support shared decision-making about salvage treatment. External and prospective validation are ongoing.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.