The use of artificial intelligence technology to predict lymph node spread in men with clinically localized prostate carcinoma
| Autor: | E D, Crawford, J T, Batuello, P, Snow, E J, Gamito, D G, McLeod, A W, Partin, N, Stone, J, Montie, R, Stock, J, Lynch, J, Brandt |
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| Rok vydání: | 2000 |
| Předmět: |
Male
Cost Control Acid Phosphatase Biopsy Needle Carcinoma Decision Trees Prostatic Neoplasms Reproducibility of Results Prostate-Specific Antigen Decision Support Techniques Databases as Topic Artificial Intelligence Risk Factors Lymphatic Metastasis Humans Lymph Node Excision False Negative Reactions Algorithms Neoplasm Staging |
| Zdroj: | Cancer. 88(9) |
| ISSN: | 0008-543X |
| Popis: | The current study assesses artificial intelligence methods to identify prostate carcinoma patients at low risk for lymph node spread. If patients can be assigned accurately to a low risk group, unnecessary lymph node dissections can be avoided, thereby reducing morbidity and costs.A rule-derivation technology for simple decision-tree analysis was trained and validated using patient data from a large database (4,133 patients) to derive low risk cutoff values for Gleason sum and prostate specific antigen (PSA) level. An empiric analysis was used to derive a low risk cutoff value for clinical TNM stage. These cutoff values then were applied to 2 additional, smaller databases (227 and 330 patients, respectively) from separate institutions.The decision-tree protocol derived cutoff values ofor = 6 for Gleason sum andor = 10.6 ng/mL for PSA. The empiric analysis yielded a clinical TNM stage low risk cutoff value ofor = T2a. When these cutoff values were applied to the larger database, 44% of patients were classified as being at low risk for lymph node metastases (0.8% false-negative rate). When the same cutoff values were applied to the smaller databases, between 11 and 43% of patients were classified as low risk with a false-negative rate of between 0.0 and 0.7%.The results of the current study indicate that a population of prostate carcinoma patients at low risk for lymph node metastases can be identified accurately using a simple decision algorithm that considers preoperative PSA, Gleason sum, and clinical TNM stage. The risk of lymph node metastases in these patients isor = 1%; therefore, pelvic lymph node dissection may be avoided safely. The implications of these findings in surgical and nonsurgical treatment are significant. |
| Databáze: | OpenAIRE |
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