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89 (95% confidence interval [CI] 0.80-0.97). However, the Japanese guideline yielded an AUC of 0.75 (95% CI 0.63-0.87). A decision curve analysis showed that the predictive scoring system had a high clinical application value, and the nomogram conferred a greater benefit than the Japanese guideline did (range of threshold within 10%-80%). This study proposed a novel predictive model to assist physicians in making treatment decisions regarding additional surgery after local excision. This study proposed a novel predictive model to assist