Objective
By the end, you will know how to turn biopsy and MRI data into an objective neurovascular preservation recommendation for each side of the prostate.
Clinical scenario
Patient with localized prostate cancer, candidate for radical prostatectomy. The decision to spare the neurovascular bundles or not defines potency and continence recovery — and it must be made side by side, not for the whole prostate.
Step by step in the app
- 1
Enter the clinical data
On the Input tab, provide age, PSA, clinical stage (cT) and prostate volume. These fields are validated before the calculation.
- 2
Map the biopsy across the 12 sectors
Tap each positive sector and record cores, Gleason and, when available, targeted biopsy and CCL. The ISUP grade group is derived automatically.
- 3
Choose the counting mode
Use the Adjusted mode (recommended) to combine targeted and systematic biopsy while keeping the worst Gleason, without double-counting.
- 4
Run PRECE
On the PRECE tab, tap Calculate. You get the probability of ECE per side across the 5 thresholds, with a 95% confidence interval.
- 5
Read the color and the recommendation
Green → full nerve-sparing; yellow → partial preservation (grade 1–2); orange/red → wide excision. The recommendation comes already translated into action.
- 6
Confirm on the 3D view
Open the 3D tab and see the per-sector heatmap. Use the snapshot to align the decision with the patient and the team.
Clinical pearls
- The decision is always side-specific — one side can be full-sparing and the other non-sparing in the same patient.
- The confidence interval matters: risk on the border between two colors deserves discussion at tumor board.
- The MRI sign of ECE (hasECESign) reinforces the decision when PRECE is borderline.
References
- Patel VR, Rocco B et al. — PRECE (n=6,360, validated at 2 centers)