Multimodal survival prediction in advanced pancreatic cancer using machine learning

J. Keyl, S. Kasper, M. Wiesweg, J. Götze, M. Schönrock, M. Sinn, A. Berger, E. Nasca, K. Kostbade, B. Schumacher, P. Markus, D. Albers, J. Treckmann, K. W. Schmid, H. U. Schildhaus, J. T. Siveke, M. Schuler, J. Kleesiek

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Existing risk scores appear insufficient to assess the individual survival risk of patients with advanced pancreatic ductal adenocarcinoma (PDAC) and do not take advantage of the variety of parameters that are collected during clinical care. Methods: In this retrospective study, we built a random survival forest model from clinical data of 203 patients with advanced PDAC. The parameters were assessed before initiation of systemic treatment and included age, CA19-9, C-reactive protein, metastatic status, neutrophil-to-lymphocyte ratio and total serum protein level. Separate models including imaging and molecular parameters were built for subgroups. Results: Over the entire cohort, a model based on clinical parameters achieved a c-index of 0.71. Our approach outperformed the American Joint Committee on Cancer (AJCC) staging system and the modified Glasgow Prognostic Score (mGPS) in the identification of high- and low-risk subgroups. Inclusion of the KRAS p.G12D mutational status could further improve the prediction, whereas radiomics data of the primary tumor only showed little benefit. In an external validation cohort of PDAC patients with liver metastases, our model achieved a c-index of 0.67 (mGPS: 0.59). Conclusions: The combination of multimodal data and machine-learning algorithms holds potential for personalized prognostication in advanced PDAC already at diagnosis.

Original languageEnglish
Article number100555
JournalESMO Open
Volume7
Issue number5
DOIs
StatePublished - Oct 2022
Externally publishedYes

Keywords

  • computed tomography
  • genetics
  • machine learning
  • pancreatic cancer
  • prognosis
  • survival analysis

Fingerprint

Dive into the research topics of 'Multimodal survival prediction in advanced pancreatic cancer using machine learning'. Together they form a unique fingerprint.

Cite this