Journal Article

Survival analysis of localized prostate cancer with deep learning

Nicholas D’Imperio, Shinjae Yoo, Xin Dai, Ji Hwan Park, Janet P. Tate, Christopher T. Rentsch, Amy C. Justice, Benjamin H. McMahon

2022

Overview

In recent years, data-driven, deep-learning-based models have shown great promise in medical risk prediction. By utilizing the large-scale Electronic Health Record data found in the U.S. Department of Veterans Affairs, the largest integrated healthcare system in the United States, we have developed an automated, personalized risk prediction model to support the clinical decision-making process for localized prostate cancer patients. This method combines the representative power of deep learning and the analytical interpretability of parametric regression models and can implement both time-dependent and static input data. To collect a comprehensive evaluation of model performances, we calculate time-dependent C-statistics C td over 2-, 5-, and 10-year time horizons using either a composite outcome or prostate cancer mortality as the target event. The composite outcome combines the Prostate-Specific Antigen (PSA) test, metastasis, and prostate cancer mortality. Our longitudinal model Recurrent Deep Survival Machine (RDSM) achieved C td 0.85 (0.83), 0.80 (0.83), and 0.76 (0.81), while the cross-sectional model Deep Survival Machine (DSM) attained C td 0.85 (0.82), 0.80 (0.82), and 0.76 (0.79) for the 2-, 5-, and 10-year composite (mortality) outcomes, respectively. In addition to estimating the survival probability, our method can quantify the uncertainty associated with the prediction. The uncertainty scores show a consistent correlation with the prediction accuracy. We find PSA and prostate cancer stage information are the most important indicators in risk prediction. Our work demonstrates the utility of the data-driven machine learning model in prostate cancer risk prediction, which can play a critical role in the clinical decision system.

• Publisher: Springer Science and Business Media LLC,Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 60 APPLIED LIFE SCIENCES / 631/114 / 631/67 / 692/308 / 692/4025 / 692/4028 / 692/499 / 692/700 / Cancer / Computational biology and bioinformatics / Cross-Sectional Studies / Decision making / Deep Learning / Electronic medical records / Health care / Health risks / Humanities and Social Sciences / Humans / Machine learning / Male / Medical research / Medicine / Metastases / Mortality / multidisciplinary / Oncology / Prediction models / Prostate cancer / Prostate-Specific Antigen / Prostatic Neoplasms / Prostatic Neoplasms - pathology / Q / R / Regression analysis / Risk factors / Science / Science & Technology / Science (multidisciplinary) / Statistical analysis / Survival / Survival Analysis / United States / Urology