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Abstract. Site-specific fatigue estimation is an essential part of wind turbine lifetime extension, with various methods depending on data availability. The present study compares probabilistic lifetime extension assessment results for rotor blades with and without load measurements. It also addresses two key questions in such assessments: the applicability of the Frandsen model for estimating waked turbulence under complex and mixed wake conditions and the extrapolation of mid-term data over longer time periods. The case study wind turbine is SWT-2.3-93, located at the edge of the Lillgrund wind farm, situated in the Øresund Strait between Denmark and Sweden. The turbine is extensively instrumented, with 5 years of data available from its supervisory control and data acquisition (SCADA) system. Although the Frandsen turbulence estimates deviate in a different manner from measurements at below- and above-rated mean wind speeds, the model remains a conservative approach for fatigue load prediction and reliability. In the current case study, the site-specific assessment using strain gauge measurements yields a 33 % higher annual fatigue reliability index after 35 years compared to a scenario based on the Frandsen estimation combined with ambient environmental data and a generic aeroelastic model. The results also demonstrate that the sensitivity of fatigue reliability to load uncertainty is negligible when load measurements are used directly but relatively high when relying on the Frandsen model in combination with a generic aeroelastic model. Overall, the high variability of the lifetime extension in different scenarios of data availability and accuracy shows the importance and added value of high-quality measurements combined with wind-farm-level SCADA and a model updated in real time (digital twins).