Using Machine Learning to Create Prognostic Systems for Primary Prostate Cancer

作者：Kevin Guan, Andy Guan, Anwar Ahmed, Andrew J. Waters, Shyh‐Han Tan, Dechang Chen · 发表于：Diagnostics · 年份：2025 · DOI：10.3390/diagnostics15192462 · 被引用次数：1 · 研究领域：Prostate Cancer Diagnosis and Treatment、Prostate Cancer Treatment and Research、AI in cancer detection

Background: Cancer staging, guided by anatomical and clinicopathologic factors, is essential for determining treatment strategies and patient prognosis. The current gold standard for prostate cancer is the American Joint Committee on Cancer (AJCC) Tumor, Lymph Node, and Metastasis (TNM) Staging System 9th Version (2024). This system incorporates five prognostic variables: tumor (T), spread to lymph nodes (N), metastasis (M), prostate-specific antigen (PSA) levels (P), and Grade Group/Gleason score (G). While effective, further refinement of prognostic systems may improve prediction of patient outcomes and support more individualized treatment. Methods: We applied the Ensemble Algorithm for Clustering Cancer Data (EACCD), an unsupervised machine learning approach. EACCD involves three steps: calculating initial dissimilarities, performing ensemble learning, and conducting hierarchical clustering. We first developed an EACCD model using the five AJCC variables (T, N, M, P, G). The model was then expanded to include two additional factors, age (A) and race (R). Prostate cancer patient data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program from the National Cancer Institute. Results: The EACCD algorithm effectively stratified patients into distinct prognostic groups, each with well-separated survival curves. The five-variable model achieved a concordance index (C-index) of 0.8293 (95% CI: 0.8245–0.8341), while the seven-variable model, including ag...