{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:05:18Z","timestamp":1789488318822,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To externally validate the Martini\u2010Klinik nomogram based on patient and clinical tumor characteristics predicting the indication for adjuvant radiation therapy after radical prostatectomy according to guideline recommendations of the European Association of Urology (EAU) in high\u2010risk prostate cancer patients treated with radical prostatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Relying on a tertiary\u2010care database, we identified high\u2010risk prostate cancer patients treated with radical prostatectomy (01\/2014\u201012\/2024). External validation was assessed in terms of accuracy, calibration and net benefit, using decision curve analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 404 high\u2010risk prostate cancer patients, 182 (45%) had the indication for adjuvant radiation therapy according to current EAU guidelines. The nomogram predicted the outcome with 79% accuracy. A high level of agreement between the predicted and observed probability of indication for adjuvant radiation therapy was observed. Minimal overestimation from the ideal predictions were noted for predicted probabilities between 25% and 50%, as well as a minimal underestimation between the predicted probability of 0% and 20% as well as 75% and 100%. In decision curve analyses, the use of the nomogram resulted in greater net benefit for all threshold probabilities between 25% and 95%, relative to both competing strategies \u2013 none or all treated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This external validation within a contemporary tertiary\u2010care cohort confirmed the ability of the Martini\u2010Klinik nomogram to predict the indication for adjuvant radiation therapy after radical prostatectomy according to current EAU guideline recommendations in high\u2010risk prostate cancer patients. The present nomogram may support clinicians in preoperative patient counseling about the risk for adjuvant treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70135","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:17:26Z","timestamp":1769696246000},"page":"710-717","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["External Validation of the Martini\u2010Klinik Nomogram Predicting the Indication for Adjuvant Radiation Therapy According to EAU Guidelines Among Patients With High\u2010Risk Prostate Cancer After Radical Prostatectomy"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-4171","authenticated-orcid":false,"given":"Carolin","family":"Siech","sequence":"first","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7992-6334","authenticated-orcid":false,"given":"Tonio","family":"Br\u00fcggemann","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh Chi","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Lauer","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Humke","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Preisser","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Kriegmair","sequence":"additional","affiliation":[{"name":"Department of Urology University Medical Center Mannheim, University of Heidelberg Heidelberg Germany"},{"name":"Department of Urology Planegg Planegg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Graefen","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Steuber","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix K. H.","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Mandel","sequence":"additional","affiliation":[{"name":"Department of Urology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"},{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2018.1429265"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2017.01.039"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03714"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02800"},{"key":"e_1_2_12_6_1","unstructured":"P.Cornford D.Tilki R. 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