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ABSTRACT Purpose We assessed the prognostic impact of the 2012 Briganti nomogram on prostate cancer (PCa) progression in intermediate-risk (IR) patients presenting with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b treated with robot assisted radical prostatectomy eventually associated with extended pelvic lymph node dissection. Materials and Methods From January 2013 to December 2021, data of surgically treated IR PCa patients were retrospectively evaluated. Only patients presenting with the above-mentioned features were considered. The 2012 Briganti nomogram was assessed either as a continuous and a categorical variable (up to the median, which was detected as 6%, vs. above the median). The association with PCa progression, defined as biochemical recurrence, and/or metastatic progression, was evaluated by Cox proportional hazard regression models. Results Overall, 147 patients were included. Compared to subjects with a nomogram score up to 6%, those presenting with a score above 6% were more likely to be younger, had larger/palpable tumors, presented with higher PSA, underwent tumor upgrading, harbored non-organ confined disease, and had positive surgical margins at final pathology. PCa progression, which occurred in 32 (21.7%) cases, was independently predicted by the 2012 Briganti nomogram both considered as a continuous (Hazard Ratio [HR]:1.04, 95% Confidence Interval [CI]:1.01-1.08;p=0.021), and a categorical variable (HR:2.32; 95%CI:1.11-4.87;p=0.026), even after adjustment for tumor upgrading. Conclusions In IR PCa patients with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b, the 2012 Briganti nomogram independently predicts PCa progression. In this challenging subset of patients, this tool can identify prognostic subgroups, independently by upgrading issues. 201 (PCa intermediaterisk intermediate risk (IR 10ngmL ngmL 10ng mL ng <10ng/mL 3 cTb cT b dissection 2021 abovementioned mentioned median 6 vs median. . median) recurrence andor or models Overall 14 included younger largerpalpable larger palpable tumors nonorgan non organ disease pathology 21.7% 217 21 7 (21.7% cases Hazard HR1.04, HR104 HR 1.04, 1 04 [HR]:1.04 95 CI1.011.08p=0.021, CI101108p0021 CIp CI 1.01 1.08 p=0.021 , 01 08 p 0 021 [CI]:1.01-1.08;p=0.021) HR2.32 HR232 2.32 2 (HR:2.32 95%CI1.114.87p=0.026, 95CI111487p0026 95%CI 1.11 4.87 p=0.026 11 4 87 026 95%CI:1.11-4.87;p=0.026) subgroups issues 20 202 21.7 (21.7 HR1 HR1.04 HR10 104 1.04 [HR]:1.0 9 CI1 011 08p CI1.011.08p=0.021 CI101108p002 101 1.0 108 p0021 p=0.02 02 [CI]:1.01-1.08;p=0.021 HR2 HR2.3 HR23 232 2.3 (HR:2.3 114 87p 95%CI1.114.87p=0.026 95CI111487p002 95CI 111 1.1 487 4.8 p0026 8 95%CI:1.11-4.87;p=0.026 21. (21. HR1.0 10 [HR]:1. CI1.011.08p=0.02 CI101108p00 1. p002 p=0.0 [CI]:1.01-1.08;p=0.02 HR2. 23 2. (HR:2. 95%CI1.114.87p=0.02 95CI111487p00 48 4. 95%CI:1.11-4.87;p=0.02 (21 HR1. [HR]:1 CI1.011.08p=0.0 CI101108p0 p00 p=0. [CI]:1.01-1.08;p=0.0 (HR:2 95%CI1.114.87p=0.0 95CI111487p0 95%CI:1.11-4.87;p=0.0 (2 [HR]: CI1.011.08p=0. CI101108p p0 p=0 [CI]:1.01-1.08;p=0. (HR: 95%CI1.114.87p=0. 95CI111487p 95%CI:1.11-4.87;p=0. ( [HR] CI1.011.08p=0 p= [CI]:1.01-1.08;p=0 (HR 95%CI1.114.87p=0 95%CI:1.11-4.87;p=0 [HR CI1.011.08p= [CI]:1.01-1.08;p= 95%CI1.114.87p= 95%CI:1.11-4.87;p= CI1.011.08p [CI]:1.01-1.08;p 95%CI1.114.87p 95%CI:1.11-4.87;p