Development and Validation of an Interpretable Artificial Intelligence Model to Predict 10-Year Prostate Cancer Mortality

Prostate cancer treatment strategies are guided by risk-stratification. This stratification can be difficult in some patients with known comorbidities. New models are needed to guide strategies and determine which patients are at risk of prostate cancer mortality. This article presents a gradient-boosting model to predict the risk of prostate cancer mortality within 10 years after a cancer diagnosis, and to provide an interpretable prediction. This work uses prospective data from the PLCO Cancer Screening and selected patients who were diagnosed with prostate cancer. During follow-up, 8776 patients were diagnosed with prostate cancer. The dataset was randomly split into a training (n = 7021) and testing (n = 1755) dataset. Accuracy was 0.98 (±0.01), and the area under the receiver operating characteristic was 0.80 (±0.04). This model can be used to support informed decision-making in prostate cancer treatment. AI interpretability provides a novel understanding of the predictions to the users.

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Development and Validation of the Korean Version of Expanded Prostate Cancer Index Composite: Questionnaire Assessing Health-Related Quality of Life after Prostate Cancer Treatment

Korean Journal of Urology ◽

10.4111/kju.2010.51.9.601 ◽

2010 ◽

Vol 51 (9) ◽

pp. 601 ◽

Cited By ~ 14

Author(s):

Kyung Jin Chung ◽

Jung Jun Kim ◽

Soo Hyun Lim ◽

Tae Heon Kim ◽

Deok Hyun Han ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Cancer Treatment ◽

Health Related Quality ◽

Prostate Cancer Treatment ◽

Korean Version ◽

Related Quality ◽

Health Related ◽

Development And Validation

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Adverse pathology as a predictor of distant metastasis and prostate cancer mortality with 20-year follow up.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.219 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 219-219

Author(s):

Michael Austin Brooks ◽

Lewis Thomas ◽

Cristina Magi-Galluzi ◽

Jianbo Li ◽

Michael Crager ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Active Surveillance ◽

Distant Metastasis ◽

Cancer Mortality ◽

High Grade ◽

Intermediate Risk ◽

Sampling Weights ◽

Prostate Cancer Mortality

219 Background: Adverse pathology (AP) at radical prostatectomy (RP) is often used as a proxy for long-term prostate cancer outcomes. The goal of this study was to assess the association of AP at RP, defined as high-grade (> Grade Group 3) and/or non-organ confined disease (pT3), with distant metastasis and prostate cancer death. Methods: A stratified cohort sample of 428 patients was used to evaluate the association of adverse pathology with the risk of distant metastases and prostate cancer-specific mortality over 20 years after prostatectomy in 2641 patients treated between 1987-2004. Cox regression of cause-specific hazards was used to estimate the absolute risk of both endpoints, with death from other causes treated as a competing risk. Subgroup analysis in patients with low/intermediate risk disease potentially eligible for active surveillance was performed. Results: Among the 428 patients, 343 had AUA Low or Intermediate risk disease and 85 had High risk disease. Median follow-up time was 15.5 years (IQR 14.6–16.6 years). Using the cohort sampling weights for estimation, at RP 29.8% of patients had high-grade disease, 42.3 % had non-organ confined disease, 19.3% had both, and thus 52.8% had AP. Adverse pathology was highly associated with metastasis and prostate cancer mortality in the overall cohort (HR 12.30, 95% CI 5.30-28.55, and 10.03, 95% CI 3.42-29.47, respectively, both p<0.001), and in the low/intermediate risk subgroup potentially eligible for active surveillance (HR 10.48, 95% CI 4.18-26.28, and 8.60, 95% CI 2.40-30.84, respectively, both p≤0.001). Conclusions: Adverse pathology at radical prostatectomy is highly associated with future development of metastasis and prostate cancer mortality and may be used as a short-term predictor of outcomes. [Table: see text]

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Radical Prostatectomy Versus Observation in Early Prostate Cancer

50 Studies Every Urologist Should Know ◽

10.1093/med/9780190655341.003.0006 ◽

2021 ◽

pp. 31-36

Author(s):

Philipp Dahm

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Prostate Specific Antigen ◽

Cancer Mortality ◽

Watchful Waiting ◽

Specific Antigen ◽

Prostate Cancer Mortality ◽

Cancer Group

This chapter provides a summary of the landmark Scandinavian Prostate Cancer Group Study Number 4 trial of men with clinically localized prostate cancer from the pre–prostate-specific antigen (PSA) era who were randomized to radical prostatectomy versus watchful waiting and were followed long term. With follow-up of more than 20 years, the results favored surgery with regard to prostate cancer mortality.

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