Artificial Intelligence Systems as Prognostic and Predictive Tools in Ovarian Cancer

BackgroundThe ability to provide accurate prognostic and predictive information to patients is becoming increasingly important as clinicians enter an era of personalized medicine. For a disease as heterogeneous as epithelial ovarian cancer, conventional algorithms become too complex for routine clinical use. This study therefore investigated the potential for an artificial intelligence model to provide this information and compared it with conventional statistical approaches.MethodsThe authors created a database comprising 668 cases of epithelial ovarian cancer during a 10-year period and collected data routinely available in a clinical environment. They also collected survival data for all the patients, then constructed an artificial intelligence model capable of comparing a variety of algorithms and classifiers alongside conventional statistical approaches such as logistic regression.ResultsThe model was used to predict overall survival and demonstrated that an artificial neural network (ANN) algorithm was capable of predicting survival with high accuracy (93 %) and an area under the curve (AUC) of 0.74 and that this outperformed logistic regression. The model also was used to predict the outcome of surgery and again showed that ANN could predict outcome (complete/optimal cytoreduction vs. suboptimal cytoreduction) with 77 % accuracy and an AUC of 0.73.ConclusionsThese data are encouraging and demonstrate that artificial intelligence systems may have a role in providing prognostic and predictive data for patients. The performance of these systems likely will improve with increasing data set size, and this needs further investigation.

[1]  M. Friedlander,et al.  The Role of Hormonal Therapy in Gynecological Cancers-Current Status and Future Directions , 2011, International Journal of Gynecologic Cancer.

[2]  Satoshi Teramukai,et al.  PIEPOC: a new prognostic index for advanced epithelial ovarian cancer--Japan Multinational Trial Organization OC01-01. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  M. Brady,et al.  Age as a prognostic factor in ovarian carcinoma: The gynecologic oncology group experience , 2010, Cancer.

[4]  C. Tropé,et al.  The prognostic significance of residual disease, FIGO substage, tumor histology, and grade in patients with FIGO stage III ovarian cancer. , 1995, Gynecologic oncology.

[5]  D. Matei,et al.  Phase II randomized placebo-controlled study of olaparib (AZD2281) in patients with platinum-sensitive relapsed serous ovarian cancer (PSR SOC). , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  R. Bristow Predicting surgical outcome for advanced ovarian cancer, surgical standards of care, and the concept of kaizen. , 2009, Gynecologic oncology.

[7]  ESMO minimum clinical recommendations for diagnosis, treatment and follow-up of ovarian cancer. , 2001, Annals of oncology : official journal of the European Society for Medical Oncology.

[8]  J. Thigpen,et al.  A Phase 3 Trial of Bevacizumab in Ovarian Cancer , 2012 .

[9]  Paul Cross,et al.  Androgen receptor expression is a biological marker for androgen sensitivity in high grade serous epithelial ovarian cancer. , 2012, Gynecologic oncology.

[10]  C. Willmott,et al.  Advantages of the mean absolute error (MAE) over the root mean square error (RMSE) in assessing average model performance , 2005 .

[11]  Y. Drew,et al.  Development of a Functional Assay for Homologous Recombination Status in Primary Cultures of Epithelial Ovarian Tumor and Correlation with Sensitivity to Poly(ADP-Ribose) Polymerase Inhibitors , 2010, Clinical Cancer Research.

[12]  Björn Olsson,et al.  Artificial intelligence techniques for bioinformatics. , 2002, Applied bioinformatics.

[13]  Peter J. Selby,et al.  Predicting Response to Bevacizumab in Ovarian Cancer: A Panel of Potential Biomarkers Informing Treatment Selection , 2013, Clinical Cancer Research.

[14]  P. Harter,et al.  The role of surgery in advanced and recurrent ovarian cancer. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  E. Trimble,et al.  Survival Effect of Maximal Cytoreductive Surgery for Advanced Ovarian Carcinoma During the Platinum Era: A Meta-Analysis. , 2023, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  E. Høgdall Cancer antigen 125 and prognosis , 2008, Current opinion in obstetrics & gynecology.

[17]  J. Neijt,et al.  Predictability of the survival of patients with advanced ovarian cancer. , 1989, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  John F Smyth,et al.  Validation of a new prognostic index for advanced epithelial ovarian cancer: results from its application to a UK-based cohort. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  D. de Jong,et al.  The prediction of progression‐free and overall survival in women with an advanced stage of epithelial ovarian carcinoma , 2009, BJOG : an international journal of obstetrics and gynaecology.

[20]  H. Ngan,et al.  FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. , 2000, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[21]  C. Robson,et al.  Expression of gonadotrophin releasing hormone receptor I is a favorable prognostic factor in epithelial ovarian cancer. , 2008, Human pathology.

[22]  R. Bristow,et al.  Limited utility of conventional criteria for predicting unresectable disease in patients with advanced stage epithelial ovarian cancer. , 2008, Gynecologic oncology.

[23]  M F Jefferson,et al.  Comparison of a genetic algorithm neural network with logistic regression for predicting outcome after surgery for patients with nonsmall cell lung carcinoma , 1997, Cancer.

[24]  R. Herrmann,et al.  ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of pancreatic cancer. , 2005, Annals of oncology : official journal of the European Society for Medical Oncology.