Is Extraprostatic Extension of Cancer Predictable? A Review of Predictive Tools and an External Validation based on a Large and a Single Center Cohort of Prostate Cancer Patients

Our aim was to review and externally validate all the available predictive tools (PTs) predicting EPE using the area under the curve (AUC), calibration plots and scaled brier score. A literature search was performed showing 19 models predicting EPE. External validation (EV) was carried out on 6360 prostate cancer (PCa) patients submitted to RP. Most of the PTs showed poor discrimination and unsatisfactory calibration. The majority of the available PTs are not reliable for the prediction of EPE in populations other than the development one; thus, they may not be completely appropriate for patients' counselling or for surgical strategy preplanning.