Feasibility of machine learning-based modeling and prediction using multiple centers data to assess intrahepatic cholangiocarcinoma outcomes

Shuang-Nan Zhou; Da-Wei Jv; Xiang-Fei Meng; Jing-Jing Zhang; Chun Liu; Ze-Yi Wu; Na Hong; Yin-Ying Lu; Ning Zhang

doi:10.1080/07853890.2022.2160008

Feasibility of machine learning-based modeling and prediction using multiple centers data to assess intrahepatic cholangiocarcinoma outcomes

Ann Med. 2023 Dec;55(1):215-223. doi: 10.1080/07853890.2022.2160008.

Authors

Shuang-Nan Zhou¹, Da-Wei Jv², Xiang-Fei Meng³, Jing-Jing Zhang⁴, Chun Liu⁵, Ze-Yi Wu⁵, Na Hong⁵, Yin-Ying Lu⁴, Ning Zhang⁴

Affiliations

¹ Senior Department of Infectious Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
² The Fifth Out-patient Department, Central Theater Command General Hospital of Chinese PLA, Wuhan, Hubei, China.
³ Faculty of Hepato-Pancrato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
⁴ Senior Department of Liver Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
⁵ Digital Health China Technologies Co., Ltd, Beijing, China.

Abstract

Background and aims: Currently, there are still no definitive consensus in the treatment of intrahepatic cholangiocarcinoma (iCCA). This study aimed to build a clinical decision support tool based on machine learning using the Surveillance, Epidemiology, and End Results (SEER) database and the data from the Fifth Medical Center of the PLA General Hospital in China.

Methods: 4,398 eligible patients from the SEER database and 504 eligible patients from the hospital data, who presented with histologically proven iCCA, were enrolled for modeling by cross-validation based on machine learning. All the models were trained using the open-source Python library scikit-survival version 0.16.0. Shapley additive explanations method was used to help clinicians better understand the obtained results. Permutation importance was calculated using library ELI5.

Results: All involved treatment modalities could contribute to a better prognosis. Three models were derived and tested using different data sources, with concordance indices of 0.67, 0.69, and 0.73, respectively. The prediction results were consistent with those under actual situations involving randomly selected patients. Model 2, trained using the hospital data, was selected to develop an online tool, due to its advantage in predicting short-term prognosis.

Conclusion: The prediction model and tool established in this study can be applied to predict the prognosis of iCCA after treatment by inputting the patient's clinical parameters or TNM stages and treatment options, thus contributing to optimal clinical decisions.KEY MESSAGESA prognostic model related to disease staging and treatment mode was conducted using the method of machine learning, based on the big data of multi centers.The online calculator can predict the short-term survival prognosis of intrahepatic cholangiocarcinoma, thus, help to make the best clinical decision.The online calculator built to calculate the mortality risk and overall survival can be easily obtained and applied.

Keywords: Intrahepatic cholangiocarcinoma; clinical decision; machine-learning; prognostic system.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bile Duct Neoplasms* / diagnosis
Bile Duct Neoplasms* / therapy
Bile Ducts, Intrahepatic / pathology
Cholangiocarcinoma* / diagnosis
Cholangiocarcinoma* / therapy
Feasibility Studies
Humans
Machine Learning
Prognosis

Grants and funding

The study was supported by Capital’s Funds for Health Improvement and Research [NO. Z181100001718075].