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一种用于精确预测肢体原发性骨肉瘤患者癌症特异性生存率的深度学习模型:一项基于人群的研究。

A deep learning model for accurately predicting cancer-specific survival in patients with primary bone sarcoma of the extremity: a population-based study.

作者信息

Cheng Debin, Liu Dong, Li Xian, Mi Zhenzhou, Zhang Zhao, Tao Weidong, Dang Jingyi, Zhu Dongze, Fu Jun, Fan Hongbin

机构信息

Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China.

Department of Orthopaedics, Shenzhen University General Hospital, Shenzhen, 518052, China.

出版信息

Clin Transl Oncol. 2024 Mar;26(3):709-719. doi: 10.1007/s12094-023-03291-6. Epub 2023 Aug 8.

Abstract

PURPOSE

Primary bone and joint sarcomas of the long bone are relatively rare neoplasms with poor prognosis. An efficient clinical tool that can accurately predict patient prognosis is not available. The current study aimed to use deep learning algorithms to develop a prediction model for the prognosis of patients with long bone sarcoma.

METHODS

Data of patients with long bone sarcoma in the extremities was collected from the Surveillance, Epidemiology, and End Results Program database from 2004 to 2014. Univariate and multivariate analyses were performed to select possible prediction features. DeepSurv, a deep learning model, was constructed for predicting cancer-specific survival rates. In addition, the classical cox proportional hazards model was established for comparison. The predictive accuracy of our models was assessed using the C-index, Integrated Brier Score, receiver operating characteristic curve, and calibration curve.

RESULTS

Age, tumor extension, histological grade, tumor size, surgery, and distant metastasis were associated with cancer-specific survival in patients with long bone sarcoma. According to loss function values, our models converged successfully and effectively learned the survival data of the training cohort. Based on the C-index, area under the curve, calibration curve, and Integrated Brier Score, the deep learning model was more accurate and flexible in predicting survival rates than the cox proportional hazards model.

CONCLUSION

A deep learning model for predicting the survival probability of patients with long bone sarcoma was constructed and validated. It is more accurate and flexible in predicting prognosis than the classical CoxPH model.

摘要

目的

长骨原发性骨与关节肉瘤是相对罕见的肿瘤,预后较差。目前尚无一种能准确预测患者预后的有效临床工具。本研究旨在利用深度学习算法开发一种长骨肉瘤患者预后的预测模型。

方法

从监测、流行病学和最终结果计划数据库中收集2004年至2014年四肢长骨肉瘤患者的数据。进行单因素和多因素分析以选择可能的预测特征。构建深度学习模型DeepSurv用于预测癌症特异性生存率。此外,建立经典的Cox比例风险模型进行比较。使用C指数、综合Brier评分、受试者工作特征曲线和校准曲线评估我们模型的预测准确性。

结果

年龄、肿瘤扩展、组织学分级、肿瘤大小、手术和远处转移与长骨肉瘤患者的癌症特异性生存相关。根据损失函数值,我们的模型成功收敛并有效学习了训练队列的生存数据。基于C指数、曲线下面积、校准曲线和综合Brier评分,深度学习模型在预测生存率方面比Cox比例风险模型更准确、更灵活。

结论

构建并验证了一种用于预测长骨肉瘤患者生存概率的深度学习模型。它在预测预后方面比经典的CoxPH模型更准确、更灵活。

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