RESULTS: Overall, 540 (25%), 1134 (54%) and 460 (21%) had low, intermediate and high-risk disease according to the D'Amico classication. The 3-year overall BCR-free survival rate was 84%. No signicant differences were observed in the 3-year BCR-free survival between low-and intermediate-risk groups based on the D'Amico classication (92 vs. 87%; P[0.1). The new MVA-based nomogram predicting BCR depicted optimal discrimination at internal validation (AUC 77%), which was higher than the accuracy of the D'Amico risk groups and the CAPRA score (AUC 71% vs. 66%, respectively). Four new risk categories were identied based on the predictors included in the MVA-based nomogram (Figure 1).CONCLUSIONS: We developed a novel preoperative risk tool integrating clinical and radiological parameters to predict early BCR. Our model exhibited higher accuracy compared to available tools in the prediction of early BCR. This stratication might assist physicians in preoperative counselling and treatment selection.