Predicting leptomeningeal disease spread after resection of brain metastases using machine learning

作者：Ishaan Ashwini Tewarie, Alexander W. Senko, Charissa Jessurun, Abigail Tianai Zhang, Alexander Hulsbergen, Luis Fernando Rendón, Jack McNulty, Marike L. D. Broekman, Luke Peng, Timothy R. Smith, John G. Phillips · 发表于：Journal of neurosurgery · 年份：2022 · DOI：10.3171/2022.8.jns22744 · 被引用次数：12 · 研究领域：Brain Metastases and Treatment、Lung Cancer Research Studies、Glioma Diagnosis and Treatment

OBJECTIVE: The incidence of leptomeningeal disease (LMD) has increased as treatments for brain metastases (BMs) have improved and patients with metastatic disease are living longer. Sample sizes of individual studies investigating LMD after surgery for BMs and its risk factors have been limited, ranging from 200 to 400 patients at risk for LMD, which only allows the use of conventional biostatistics. Here, the authors used machine learning techniques to enhance LMD prediction in a cohort of surgically treated BMs. METHODS: A conditional survival forest, a Cox proportional hazards model, an extreme gradient boosting (XGBoost) classifier, an extra trees classifier, and logistic regression were trained. A synthetic minority oversampling technique (SMOTE) was used to train the models and handle the inherent class imbalance. Patients were divided into an 80:20 training and test set. Fivefold cross-validation was used on the training set for hyperparameter optimization. Patients eligible for study inclusion were adults who had consecutively undergone neurosurgical BM treatment, had been admitted to Brigham and Women's Hospital from January 2007 through December 2019, and had a minimum of 1 month of follow-up after neurosurgical treatment. RESULTS: A total of 1054 surgically treated BM patients were included in this analysis. LMD occurred in 168 patients (15.9%) at a median of 7.05 months after BM diagnosis. The discrimination of LMD occurrence was optimal using an XGboost algorithm...