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The Toronto Postliv...
The Toronto Postliver Transplantation Hepatocellular Carcinoma Recurrence Calculator : A Machine Learning Approach
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- Ivanics, Tommy (author)
- Uppsala universitet,Gastrointestinalkirurgi,Univ OfToronto, Univ Hlth Network, Toronto Gen Hosp, Multiorgan Transplant Program,Div Gen Surg, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI 48202 USA.
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- Nelson, Walter (author)
- Centre for Data Science and Digital Health Hamilton Health Sciences Hamilton ON Canada;Department of Statistical Sciences University of Toronto Toronto ON Canada
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- Patel, Madhukar S. (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada
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- Claasen, Marco P.A.W. (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada;Department of Surgery Erasmus MC University Medical Center Rotterdam the Netherlands
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- Lau, Lawrence (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada
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- Gorgen, Andre (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada
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- Abreu, Phillipe (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada
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- Goldenberg, Anna (author)
- SickKids Research Institute University of Toronto Toronto Canada
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- Erdman, Lauren (author)
- SickKids Research Institute University of Toronto Toronto Canada;Center for Computational Medicine SickKids Research Institute Toronto Canada
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- Sapisochin, Gonzalo (author)
- Multi‐Organ Transplant Program Division of General Surgery Toronto General Hospital University Health Network University of Toronto Toronto Canada
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(creator_code:org_t)
- 2021-11-05
- 2022
- English.
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In: Liver transplantation. - : John Wiley & Sons. - 1527-6465 .- 1527-6473. ; 28:4, s. 593-602
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Liver transplantation (LT) listing criteria for hepatocellular carcinoma (HCC) remain controversial. To optimize the utility of limited donor organs, this study aims to leverage machine learning to develop an accurate posttransplantation HCC recurrence prediction calculator. Patients with HCC listed for LT from 2000 to 2016 were identified, with 739 patients who underwent LT used for modeling. Data included serial imaging, alpha-fetoprotein (AFP), locoregional therapies, treatment response, and posttransplantation outcomes. We compared the CoxNet (regularized Cox regression), survival random forest, survival support vector machine, and DeepSurv machine learning algorithms via the mean cross-validated concordance index. We validated the selected CoxNet model by comparing it with other currently available recurrence risk algorithms on a held-out test set (AFP, Model of Recurrence After Liver Transplant [MORAL], and Hazard Associated with liver Transplantation for Hepatocellular Carcinoma [HALT-HCC score]). The developed CoxNet-based recurrence prediction model showed a satisfying overall concordance score of 0.75 (95% confidence interval [CI], 0.64-0.84). In comparison, the recalibrated risk algorithms' concordance scores were as follows: AFP score 0.64 (outperformed by the CoxNet model, 1-sided 95% CI, >0.01; P = 0.04) and MORAL score 0.64 (outperformed by the CoxNet model 1-sided 95% CI, >0.02; P = 0.03). The recalibrated HALT-HCC score performed well with a concordance of 0.72 (95% CI, 0.63-0.81) and was not significantly outperformed (1-sided 95% CI, >= 0.05; P = 0.29). Developing a comprehensive posttransplantation HCC recurrence risk calculator using machine learning is feasible and can yield higher accuracy than other available risk scores. Further research is needed to confirm the utility of machine learning in this setting.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Transplantation
- Hepatology
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ivanics, Tommy
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Nelson, Walter
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Patel, Madhukar ...
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Claasen, Marco P ...
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Lau, Lawrence
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Gorgen, Andre
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Abreu, Phillipe
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Goldenberg, Anna
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Erdman, Lauren
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Sapisochin, Gonz ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Liver transplant ...
- By the university
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Uppsala University