Differential prognostic impact of favourable prostate cancer pathology risk score patterns predicted by Briganti’s 2012 nomogram across EAU risk groups: Analysis of 757 cases treated with robotic surgery

Introduction The aim of this study was to evaluate the prognostic impact of favourable prostate cancer (PCa) pathology patterns through Briganti’s 2012 nomogram and beyond EAU risk classes in patients treated with robotic surgery. Material and methods We analysed 757 patients from January 2013 to December 2021 with favourable pathology features (ISUP 1-3, pT2/pT3a, and pN0/x) and available follow-up. Pathologic features were scored from zero (ISUP 1 + pT2) to three (ISUP 3 + pT3a). Associations with Briganti’s 2012 nomogram by EAU risk class were evaluated to determine the prognostic impact on PCa progression, defined as biochemical persistence/recurrence or loco-regional/metastatic recurrence. Results Favourable pathology risk scores were most commonly grades one (49%) and two (30.95%), followed by zero (15.2%) and three (4.9%). After adjusting for EAU prognostic groups, higher nomogram scores were associated with increased risk scores of two and three. PCa progression occurred in 12.7% of cases after a mean follow-up of 92.1 months. Patients with recurrence had a worse prognosis as risk scores increased from one to three, even after adjustment for Briganti’s 2012 nomogram by EAU class. Conclusions Favourable pathology risk scores, grouped by Briganti’s 2012 and EAU nomograms, impact prognosis. As scores increase, the likelihood of disease progression rises, potentially influencing treatment strategies.