Combination possibility and deep learning model as clinical decision-aided approach for prostate cancer

This study aims to introduce as proof of concept a combination model for classification of prostate cancer using deep learning approaches. We utilized patients with prostate cancer who underwent surgical treatment representing the various conditions of disease progression. All possible combinations of significant variables from logistic regression and correlation analyses were determined from study data sets. The combination possibility and deep learning model was developed to predict these combinations that represented clinically meaningful patient’s subgroups. The observed relative frequencies of different tumor stages and Gleason score Gls changes from biopsy to prostatectomy were available for each group. Deep learning models and seven machine learning approaches were compared for the classification performance of Gleason score changes and pT2 stage. Deep models achieved the highest F1 scores by pT2 tumors (0.849) and Gls change (0.574). Combination possibility and deep learning model is a useful decision-aided tool for prostate cancer and to group patients with prostate cancer into clinically meaningful groups.

[1]  John T. Wei,et al.  Selective detection of histologically aggressive prostate cancer , 2012, Cancer.

[2]  S. Edge AJCC Cancer Staging Handbook: From the AJCC Cancer Staging Manual , 2002 .

[3]  P. Stattin,et al.  Population based study of predictors of adverse pathology among candidates for active surveillance with Gleason 6 prostate cancer. , 2014, The Journal of urology.

[4]  R. Cohen,et al.  Prediction of pathological stage and clinical outcome in prostate cancer: an improved pre-operative model incorporating biopsy-determined intraductal carcinoma. , 1998, British journal of urology.

[5]  Heng-Tze Cheng,et al.  Wide & Deep Learning for Recommender Systems , 2016, DLRS@RecSys.

[6]  A. Semjonow,et al.  The presence of positive surgical margins in patients with organ-confined prostate cancer results in biochemical recurrence at a similar rate to that in patients with extracapsular extension and PSA ≤ 10 ng/ml. , 2014, Urologic oncology.

[7]  A. Partin,et al.  Prediction of metastatic potential in an animal model of prostate cancer: flow cytometric quantification of cell surface charge. , 1989, The Journal of urology.

[8]  J. Malin,et al.  Development and validation of a prediction model for the risk of developing febrile neutropenia in the first cycle of chemotherapy among elderly patients with breast, lung, colorectal, and prostate cancer , 2010, Supportive Care in Cancer.

[9]  Aaron J Fisher,et al.  A Bayesian hierarchical model for prediction of latent health states from multiple data sources with application to active surveillance of prostate cancer , 2015, Biometrics.

[10]  Hartwig Huland,et al.  Counseling men with prostate cancer: a nomogram for predicting the presence of small, moderately differentiated, confined tumors. , 2003, The Journal of urology.

[11]  Lars Stegger,et al.  Concept and implementation of a single source information system in nuclear medicine for myocardial scintigraphy (SPECT-CT data) , 2010, Thrombosis and Haemostasis.

[12]  Jianfeng Xu,et al.  Using graded response model for the prediction of prostate cancer risk , 2012, Human Genetics.

[13]  Clinical predictors of upgrading to Gleason grade 4 or 5 disease at radical prostatectomy: potential implications for patient selection for radiation and androgen suppression therapy. , 1999 .

[14]  T. Choueiri,et al.  Incidence and Predictors of Upgrading and Up Staging among 10,000 Contemporary Patients with Low Risk Prostate Cancer. , 2015, The Journal of urology.

[15]  Jimmy Ba,et al.  Adam: A Method for Stochastic Optimization , 2014, ICLR.

[16]  H. G. van der Poel,et al.  PREDICT: model for prediction of survival in localized prostate cancer , 2015, World Journal of Urology.

[17]  Geoffrey E. Hinton,et al.  Deep Learning , 2015, Nature.

[18]  V. R. McCready,et al.  A model-based method for the prediction of whole-body absorbed dose and bone marrow toxicity for 186Re-HEDP treatment of skeletal metastases from prostate cancer , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[19]  A W Partin,et al.  Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. , 2002, Urology.

[20]  J. Brooks,et al.  Nationwide prevalence of lymph node metastases in Gleason score 3 + 3 = 6 prostate cancer , 2014, Pathology.

[21]  Thomas Wiegel,et al.  EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. , 2011, European urology.

[22]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[23]  Thomas Yu,et al.  Prediction of overall survival for patients with metastatic castration-resistant prostate cancer: development of a prognostic model through a crowdsourced challenge with open clinical trial data. , 2017, The Lancet. Oncology.

[24]  Nitish Srivastava,et al.  Dropout: a simple way to prevent neural networks from overfitting , 2014, J. Mach. Learn. Res..

[25]  L. Egevad,et al.  A Contemporary Prostate Cancer Grading System: A Validated Alternative to the Gleason Score. , 2016, European urology.

[26]  Peter Bankhead,et al.  QuPath: Open source software for digital pathology image analysis , 2017, Scientific Reports.

[27]  W. Youden,et al.  Index for rating diagnostic tests , 1950, Cancer.

[28]  Jing Zhang,et al.  Using support vector machine analysis to assess PartinMR: A new prediction model for organ‐confined prostate cancer , 2018, Journal of magnetic resonance imaging : JMRI.

[29]  M. Moerland,et al.  Development and internal validation of a multivariable prediction model for biochemical failure after whole-gland salvage iodine-125 prostate brachytherapy for recurrent prostate cancer. , 2016, Brachytherapy.

[30]  John A. W. McCall,et al.  Machine learning for improved pathological staging of prostate cancer: A performance comparison on a range of classifiers , 2012, Artif. Intell. Medicine.

[31]  Giovanni Acampora,et al.  Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model , 2016, PloS one.

[32]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[33]  Sohee Kim,et al.  Lifestyle Risk Prediction Model for Prostate Cancer in a Korean Population , 2017, Cancer research and treatment : official journal of Korean Cancer Association.

[34]  A. Renshaw,et al.  Biochemical Outcome after radical prostatectomy, external beam Radiation Therapy, or interstitial Radiation therapy for clinically localized prostate cancer , 1998 .

[35]  Gary K. Chen,et al.  Reproducibility, Performance, and Clinical Utility of a Genetic Risk Prediction Model for Prostate Cancer in Japanese , 2012, PloS one.

[36]  Ronald C. Chen,et al.  Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients. , 2015, International journal of radiation oncology, biology, physics.

[37]  M. Kattan,et al.  Making and evaluating a statistical prediction model for the absolute risk of prostate cancer recurrence , 2011, Cancer.

[38]  M. Leeflang,et al.  Bias in sensitivity and specificity caused by data-driven selection of optimal cutoff values: mechanisms, magnitude, and solutions. , 2008, Clinical chemistry.

[39]  M. Kattan,et al.  Predictive and prognostic models in radical prostatectomy candidates: a critical analysis of the literature. , 2010, European urology.

[40]  D. Chan,et al.  The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. , 1993, The Journal of urology.

[41]  David C. Miller,et al.  askMUSIC: Leveraging a Clinical Registry to Develop a New Machine Learning Model to Inform Patients of Prostate Cancer Treatments Chosen by Similar Men. , 2019, European urology.

[42]  Hua Tan,et al.  Prediction of treatment efficacy for prostate cancer using a mathematical model , 2016, Scientific Reports.

[43]  Doris Xin,et al.  DWCox: A density-weighted Cox model for outlier-robust prediction of prostate cancer survival , 2016, F1000Research.

[44]  R W Veltri,et al.  Prediction of prostate carcinoma stage by quantitative biopsy pathology , 2001, Cancer.

[45]  S. Aedo,et al.  Prediction model for early biochemical recurrence after radical prostatectomy based on the Cancer of the Prostate Risk Assessment score and the presence of secondary circulating prostate cells , 2016, BJU international.

[46]  U. Jelen,et al.  The influence of the local effect model parameters on the prediction of the tumor control probability for prostate cancer , 2014, Physics in medicine and biology.

[47]  Hartwig Huland,et al.  Quantitative biopsy pathology for the prediction of pathologically organ‐confined prostate carcinoma , 2003, Cancer.

[48]  F. Wawroschek,et al.  Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate‐specific antigen (PSA) level of ≤10 ng/mL and biopsy Gleason score of ≤6, and their influence on PSA progression‐free survival after radical prostatectomy , 2006, BJU international.

[49]  Yan-feng Li,et al.  The establishment and evaluation of a new model for the prediction of prostate cancer , 2017, Medicine.

[50]  P. Walsh,et al.  Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. , 1994, JAMA.

[51]  Misop Han,et al.  Prediction of pathological stage based on clinical stage, serum prostate‐specific antigen, and biopsy Gleason score: Partin Tables in the contemporary era , 2017, BJU international.

[52]  Scott H. Kurtzman,et al.  AJCC cancer staging atlas , 2006 .

[53]  Fleur Fritz,et al.  HIS-based Kaplan-Meier plots - a single source approach for documenting and reusing routine survival information , 2011, BMC Medical Informatics Decis. Mak..

[54]  M. Menon,et al.  Population‐Based External Validation of the Updated 2012 Partin Tables in Contemporary North American Prostate Cancer Patients , 2017, The Prostate.

[55]  Martin Dugas,et al.  HIS-based electronic documentation can significantly reduce the time from biopsy to final report for prostate tumours and supports quality management as well as clinical research , 2009, BMC Medical Informatics Decis. Mak..

[56]  Okyaz Eminaga,et al.  CMDX©-based single source information system for simplified quality management and clinical research in prostate cancer , 2012, BMC Medical Informatics and Decision Making.

[57]  C. Roehrborn,et al.  Significant upgrading affects a third of men diagnosed with prostate cancer: predictive nomogram and internal validation , 2006, BJU international.

[58]  L. Egevad,et al.  The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma , 2005, The American journal of surgical pathology.

[59]  A. Young Recurrence. , 2020, JAMA.

[60]  M. Roobol,et al.  Active surveillance for low-risk prostate cancer worldwide: the PRIAS study. , 2013, European urology.

[61]  A. Semjonow,et al.  Prostate cancers detected on repeat prostate biopsies show spatial distributions that differ from those detected on the initial biopsies , 2015, BJU international.