{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:30:20Z","timestamp":1786437020337,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Objectives<\/jats:title>\n To evaluate biochemical recurrence\u2010free survival (BRFS) and metastasis\u2010free survival (MFS) as potential intermediate clinical endpoints (ICEs) for overall survival (OS) in patients undergoing salvage radical prostatectomy (sRP).<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n Evaluable patients were selected from a retrospective dataset, resulting in a cohort of 879 patients with recurrent, non\u2010metastatic, hormone\u2010sensitive prostate cancer treated with sRP at 13 centres. ICE surrogacy was evaluated using a two\u2010stage approach: (i) at the individual\u2010patient level by fitting Clayton copula models and estimating Kendall's ( >0.7 indicating a strong association) and (ii) at the centre level, by fitting weighted linear regression of 5\u2010year OS on 3\u2010year BRFS and MFS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The two\u2010step analysis included 759 patients for BRFS (366 events) and 476 for MFS (137 events), with median follow\u2010up of 37\u2009months (95% confidence interval [CI] 36\u201342\u2009months) and 34\u2009months (95% CI 31\u201337\u2009months), respectively. At the individual\u2010patient level, MFS showed a strong association with OS (Kendall's 0.85, 95% CI 0.82\u20130.88), which was not observed for BRFS (Kendall's 0.63, 95% CI 0.56\u20130.69). At the centre level, neither 3\u2010year BRFS (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.15; slope\u2009=\u20090.34,\n P<\/jats:italic>\n \u2009=\u20090.2) nor 3\u2010year MFS (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.21; slope\u2009=\u20090.26,\n P<\/jats:italic>\n \u2009=\u20090.14) predicted 5\u2010year OS with sufficient explanatory power. Limitations include the fact that centre\u2010level analysis was based on single\u2010arm associations rather than on treatment\u2010effect surrogacy across arms, and retrospective data collection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The BRFS should not be used as a surrogate endpoint in the sRP setting. MFS requires further validation in future prospective studies to confirm its association with OS. Patient\u2010reported outcomes, such as quality\u2010of\u2010life and treatment\u2010related toxicity, should be considered in parallel with OS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70352","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:13:19Z","timestamp":1781583199000},"page":"430-437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intermediate clinical endpoints as surrogates for overall survival after salvage prostatectomy"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2792-9828","authenticated-orcid":false,"given":"Navid","family":"Roessler","sequence":"first","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Medical University of Vienna Vienna Austria"},{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7814-5830","authenticated-orcid":false,"given":"Zuzanna","family":"Nowicka","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine Medical University of \u0141\u00f3d\u017a \u0141\u00f3d\u017a Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-0827","authenticated-orcid":false,"given":"Marcin","family":"Miszczyk","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Medical University of Vienna Vienna Austria"},{"name":"Collegium Medicum, Faculty of Medicine WSB University D\u0105browa G\u00f3rnicza Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3831-1632","authenticated-orcid":false,"given":"Giorgio","family":"Calleris","sequence":"additional","affiliation":[{"name":"Department of Urology, Citt\u00e0 della Salute e della Scienza University of Torino School of Medicine Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4125-3874","authenticated-orcid":false,"given":"Alessandro","family":"Dematteis","sequence":"additional","affiliation":[{"name":"Department of Urology, Citt\u00e0 della Salute e della Scienza University of Torino School of Medicine Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-3883","authenticated-orcid":false,"given":"Malte W.","family":"Vetterlein","sequence":"additional","affiliation":[{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Martini\u2010Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Hamburg 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