Department of Otorhinolaryngology, Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Sci Rep. 2023 Jun 15;13(1):9734. doi: 10.1038/s41598-023-35627-1.
Most recent survival prediction has been based on TNM staging, which does not provide individualized information. However, clinical factors including performance status, age, sex, and smoking might influence survival. Therefore, we used artificial intelligence (AI) to analyze various clinical factors to precisely predict the survival of patients with larynx squamous cell carcinoma (LSCC). We included patients with LSCC (N = 1026) who received definitive treatment from 2002 to 2020. Age, sex, smoking, alcohol consumption, Eastern Cooperative Oncology Group (ECOG) performance status, location of tumor, TNM stage, and treatment methods were analyzed using deep neural network (DNN) with multi-classification and regression, random survival forest (RSF), and Cox proportional hazards (COX-PH) model for prediction of overall survival. Each model was confirmed with five-fold cross validation, and performance was evaluated using linear slope, y-intercept, and C-index. The DNN with multi-classification model demonstrated the highest prediction power (1.000 ± 0.047, 0.126 ± 0.762, and 0.859 ± 0.018 for slope, y-intercept, and C-index, respectively), and the prediction survival curve showed the strongest agreement with the validation survival curve, followed by DNN with regression (0.731 ± 0.048, 9.659 ± 0.964, and 0.893 ± 0.017, respectively). The DNN model produced with only T/N staging showed the poorest survival prediction. When predicting the survival of LSCC patients, various clinical factors should be considered. In the present study, DNN with multi-class was shown to be an appropriate method for survival prediction. AI analysis may predict survival more accurately and improve oncologic outcomes.
最近的生存预测主要基于 TNM 分期,它不能提供个体化信息。然而,临床因素包括身体状况、年龄、性别和吸烟状况可能会影响生存。因此,我们使用人工智能 (AI) 来分析各种临床因素,以精确预测喉鳞状细胞癌 (LSCC) 患者的生存情况。我们纳入了 2002 年至 2020 年接受根治性治疗的 LSCC 患者 (N=1026)。年龄、性别、吸烟、饮酒、东部肿瘤协作组 (ECOG) 体能状态、肿瘤位置、TNM 分期和治疗方法使用多分类和回归的深度神经网络 (DNN)、随机生存森林 (RSF) 和 Cox 比例风险 (COX-PH) 模型进行分析,用于预测总生存期。每个模型都经过五重交叉验证确认,并使用线性斜率、y 截距和 C 指数评估性能。多分类 DNN 模型表现出最高的预测能力 (斜率、y 截距和 C 指数分别为 1.000±0.047、0.126±0.762 和 0.859±0.018),预测生存曲线与验证生存曲线吻合度最强,其次是回归 DNN (斜率、y 截距和 C 指数分别为 0.731±0.048、9.659±0.964 和 0.893±0.017)。仅使用 T/N 分期生成的 DNN 模型对生存预测的效果最差。在预测 LSCC 患者的生存时,应考虑各种临床因素。在本研究中,多分类 DNN 被证明是一种用于生存预测的合适方法。AI 分析可能会更准确地预测生存,并改善肿瘤学结果。