为了识别可切除的胰腺体/尾腺癌（PBTA）患者中预测复发的预后CT特征，并建立基于CT的术前风险分层预测表。回顾性纳入了258例接受手术的可切除PBTA患者（发展组n = 172；验证组n = 86），分析其临床和CT特征。进行逐步Cox比例风险分析以识别预后特征，并构建预测无复发生存（RFS）的预测表。验证了基于CT的预测表的预后表现，并与第8版美国癌症联合委员会（AJCC）病理分期系统进行比较。 在发展组中，识别了下列五个用于预测复发的CT特征来构建预测表：静脉期肿瘤密度、肿瘤坏死、邻近器官侵犯、脾静脉侵犯、上肠系膜静脉/门静脉紧挨。在验证组中，基于CT的预测表显示了0.65的一致性指数（95%置信区间：0.58-0.73），比第8版AJCC分期系统更高。预测表在0.5、1和2年时预测复发的曲线下面积分别为0.66、0.71和0.72。将患者分为高风险组和低风险组，1年复发概率分别为0.73和0.43。 所提出的预测表在术前环境中为可切除PBTA患者提供准确的复发风险分层，并可用于辅助临床决策。所提出的基于CT的预测表，基于易获取的CT特征，可以作为进一步分层评估胰腺体/尾腺癌患者复发风险的有效便捷工具。 • 基于CT的预测表，结合了五个常用的CT特征，成功地术前将可切除的PBTA患者分成不同的预后组。 • 静脉期肿瘤密度、肿瘤坏死、脾静脉侵犯、邻近器官侵犯和上肠系膜静脉/门静脉紧挨与可切除PBTA患者的RFS相关。 • 基于CT的预测表在预测复发方面的表现优于第8版AJCC分期系统。 © 2023. 作者，由欧洲放射学学会独家授权使用。

To identify prognostic CT features that predict recurrence in patients with resectable pancreatic body/tail adenocarcinoma (PBTA) and construct a CT-based nomogram for preoperative risk stratification.A total of 258 patients with resectable PBTA who underwent upfront surgery were retrospectively enrolled (development cohort, n = 172; validation cohort, n = 86), and their clinical and CT features were analyzed. Stepwise Cox proportional hazard analysis was performed to identify prognostic features and construct a predictive nomogram for recurrence-free survival (RFS). The prognostic performance of the CT-based nomogram was validated and compared to the 8th American Joint Committee on Cancer (AJCC) pathological staging system.In the development cohort, the following five CT features for predicting recurrence were identified to construct the nomogram: tumor density in the venous phase, tumor necrosis, adjacent organ invasion, splenic vein invasion, and superior mesenteric vein/portal vein abutment. In the validation cohort, the CT-based nomogram showed a concordance index of 0.65 (95% confidence interval: 0.58-0.73), which was higher than the 8th AJCC staging system. The area under the curves of the nomogram for predicting recurrence at 0.5, 1, and 2 years were 0.66, 0.71, and 0.72, respectively. Patients were categorized into high- and low-risk groups with 1-year recurrence probabilities of 0.73 and 0.43, respectively.The proposed nomogram provided accurate recurrence risk stratification for patients with resectable PBTA in a preoperative setting and may be used to facilitate clinical decision-making.The proposed CT-based nomogram, based on easily available CT features, may serve as an effective and convenient tool for stratifying further the recurrence risk of patients with pancreatic body/tail adenocarcinoma.• The CT-based nomogram, incorporating five commonly used CT features, successfully preoperatively stratified patients with resectable PBTA into distinct prognosis groups. • Tumor density in the venous phase, tumor necrosis, splenic vein invasion, adjacent organ invasion, and superior mesenteric vein/portal vein abutment were associated with RFS in patients with resectable PBTA. • The CT-based nomogram exhibited better predictive performance for recurrence than the 8th AJCC staging system.© 2023. The Author(s), under exclusive licence to European Society of Radiology.