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Contemporary seminal vesicle invasion (SVI) rates in National Cancer Comprehensive Network (NCCN) high‐risk prostate cancer (PCa) patients are not well known but essential for treatment planning. Therefore, the study examined SVI rates according to individual patient characteristics for purpose of treatment planning. Out of 4975 patients, 28% had SVI. SVI rate ranged from 8% to 89% according to clinical T stage, prostate‐specific antigen (PSA), biopsy Gleason Grade Group and percentage of positive biopsy cores. In the external validation cohort, the current model achieved 77.6% accuracy vs 73.7% for Memorial Sloan Kettering Cancer Centre (MSKCC) vs 68.6% for Gallina et al. Calibration was better than for the two alternatives: departures from ideal predictions were 6.0% for the current model vs 9.8% for MSKCC vs 38.5% for Gallina et al. In DCAs, the current model outperformed both alternatives. More than a quarter of NCCN high‐risk PCa patients harbored SVI. Since SVI positivity rate varies from 8% to 89%, the currently developed model offers a valuable approach to distinguish between low and high SVI risk patients.
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