Prediction of Postoperative Pathologic Risk Factors in Cervical Cancer Patients Treated with Radical Hysterectomy by Machine Learning

Curr Oncol. 2022 Dec 6;29(12):9613-9629. doi: 10.3390/curroncol29120755.

Abstract

Pretherapeutic serological parameters play a predictive role in pathologic risk factors (PRF), which correlate with treatment and prognosis in cervical cancer (CC). However, the method of pre-operative prediction to PRF is limited and the clinical availability of machine learning methods remains unknown in CC. Overall, 1260 early-stage CC patients treated with radical hysterectomy (RH) were randomly split into training and test cohorts. Six machine learning classifiers, including Gradient Boosting Machine, Support Vector Machine with Gaussian kernel, Random Forest, Conditional Random Forest, Naive Bayes, and Elastic Net, were used to derive diagnostic information from nine clinical factors and 75 parameters readily available from pretreatment peripheral blood tests. The best results were obtained by RF in deep stromal infiltration prediction with an accuracy of 70.8% and AUC of 0.767. The highest accuracy and AUC for predicting lymphatic metastasis with Cforest were 64.3% and 0.620, respectively. The highest accuracy of prediction for lymphavascular space invasion with EN was 59.7% and the AUC was 0.628. Blood markers, including D-dimer and uric acid, were associated with PRF. Machine learning methods can provide critical diagnostic prediction on PRF in CC before surgical intervention. The use of predictive algorithms may facilitate individualized treatment options through diagnostic stratification.

Keywords: blood biomarker; cervical cancer; deep stromal infiltration; lymph node metastasis; lymph-vascular space invasion; machine learning methods.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Bayes Theorem
  • Female
  • Humans
  • Hysterectomy
  • Machine Learning
  • Uterine Cervical Neoplasms* / pathology
  • Uterine Cervical Neoplasms* / surgery

Grants and funding

This research was funded by the National Natural Science Foundation of China (D.Z., grant number 62176267), the Natural Science Foundation of Qinghai Province (D.Z., grant number 2021-ZJ-922); the CAMS Innovation Fund for Medical Sciences (D.Z., grant number 2021-I2M-C&T-B-048), the Beijing Hope Run Special Fund of Cancer Foundation of China (D.Z., grant number LC2021A10) and Capital’s Funds for Health Improvement and Research (D.Z., grant number 2022-2-4026).