Fig. 5. Cox-PH M5 expressed as a simplified survival nomogram for clinical application, by which, with AI-determined ECE and RadS at MRI, as well as with PSA, the predicted 1-year, 3-year and 5-year relapse-free survival rate can be calculated preoperatively.

Red dots mark the prediction process of a case with PSA > 20 ng/ml, high-risk RadS and high-risk AI-predicted ECE (a). The resulting nomogram outputs 7-level risk categories, showing different BCR-free survival rates (b). Relying on M5, a more simplified triple-stratifying scheme for 5-year BCR risk is presented with a decision tree (c), where triple-positive patients have extremely higher relapse risk than triple-negative patients 5 years after surgery. The net clinical benefit of iBCR-Net (Cox-PH M5, Cox-GBM M5, Cox-DL M5) against conventional D’Amico, CAPRA, and CAPRA-S tested with a pairwise log-rank test (d) and a decision curve analysis (e).