Skip to main content
Top
Published in: Annals of Surgical Oncology 12/2015

01-11-2015 | Gynecologic Oncology

Artificial Intelligence Systems as Prognostic and Predictive Tools in Ovarian Cancer

Authors: A. Enshaei, C. N. Robson, R. J. Edmondson

Published in: Annals of Surgical Oncology | Issue 12/2015

Login to get access

Abstract

Background

The ability to provide accurate prognostic and predictive information to patients is becoming increasingly important as clinicians enter an era of personalized medicine. For a disease as heterogeneous as epithelial ovarian cancer, conventional algorithms become too complex for routine clinical use. This study therefore investigated the potential for an artificial intelligence model to provide this information and compared it with conventional statistical approaches.

Methods

The authors created a database comprising 668 cases of epithelial ovarian cancer during a 10-year period and collected data routinely available in a clinical environment. They also collected survival data for all the patients, then constructed an artificial intelligence model capable of comparing a variety of algorithms and classifiers alongside conventional statistical approaches such as logistic regression.

Results

The model was used to predict overall survival and demonstrated that an artificial neural network (ANN) algorithm was capable of predicting survival with high accuracy (93 %) and an area under the curve (AUC) of 0.74 and that this outperformed logistic regression. The model also was used to predict the outcome of surgery and again showed that ANN could predict outcome (complete/optimal cytoreduction vs. suboptimal cytoreduction) with 77 % accuracy and an AUC of 0.73.

Conclusions

These data are encouraging and demonstrate that artificial intelligence systems may have a role in providing prognostic and predictive data for patients. The performance of these systems likely will improve with increasing data set size, and this needs further investigation.
Appendix
Available only for authorised users
Literature
1.
go back to reference ESMO Minimum clinical recommendations for diagnosis, treatment, and follow-up of ovarian cancer. Ann Oncol. 2001;12:1205–7. ESMO Minimum clinical recommendations for diagnosis, treatment, and follow-up of ovarian cancer. Ann Oncol. 2001;12:1205–7.
2.
3.
go back to reference Benedet J, et al. FIGO staging classifications and clinical practice gudelines in the management of gynecologic cancers. Int J Gynecol Obstet. 2000;70:209–62.CrossRef Benedet J, et al. FIGO staging classifications and clinical practice gudelines in the management of gynecologic cancers. Int J Gynecol Obstet. 2000;70:209–62.CrossRef
4.
go back to reference van Houwelingen J, et al. Predictability of the survival of patients with advanced ovarian cancer. J Clin Oncol. 1989;7:769–73.PubMed van Houwelingen J, et al. Predictability of the survival of patients with advanced ovarian cancer. J Clin Oncol. 1989;7:769–73.PubMed
5.
go back to reference Makar AP, et al. The prognostic significance of residual disease, FIGO substage, tumor histology, and grade in patients with FIGO stage III ovarian cancer. Gynecol Oncol. 1995;56:175–80.CrossRefPubMed Makar AP, et al. The prognostic significance of residual disease, FIGO substage, tumor histology, and grade in patients with FIGO stage III ovarian cancer. Gynecol Oncol. 1995;56:175–80.CrossRefPubMed
8.
go back to reference du Bois, A, Harter P. The role of surgery in advanced and recurrent ovarian cancer. Ann Oncol. 2006;17(Suppl 10):x235–40.CrossRefPubMed du Bois, A, Harter P. The role of surgery in advanced and recurrent ovarian cancer. Ann Oncol. 2006;17(Suppl 10):x235–40.CrossRefPubMed
9.
go back to reference Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM, ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365(26):2484–96.CrossRefPubMed Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM, ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365(26):2484–96.CrossRefPubMed
10.
go back to reference Ledermann JA, Harter P, Gourley C, Friedlander M, Vergote IB, Rustin GJS, et al. Phase II randomized placebo-controlled study of olaparib (AZD2281) in patients with platinum-sensitive relapsed serous ovarian cancer (PSR SOC). J Clin Oncol. 2011;29(Suppl 15):5003. Ledermann JA, Harter P, Gourley C, Friedlander M, Vergote IB, Rustin GJS, et al. Phase II randomized placebo-controlled study of olaparib (AZD2281) in patients with platinum-sensitive relapsed serous ovarian cancer (PSR SOC). J Clin Oncol. 2011;29(Suppl 15):5003.
11.
go back to reference Sjoquist K, et al. The Role of Hormonal therapy in Gynaecological Cancers – Current Status and Future Directions. Int J Gynecol Cancer. 2011;21:1328–33.PubMed Sjoquist K, et al. The Role of Hormonal therapy in Gynaecological Cancers – Current Status and Future Directions. Int J Gynecol Cancer. 2011;21:1328–33.PubMed
12.
go back to reference Collinson F, et al. Predicting response to bevacizumab in ovarian cancer: a panel of potential biomarkers informing treatment selection. Clin Cancer Res. 2013;19:5227–39.PubMedCentralCrossRefPubMed Collinson F, et al. Predicting response to bevacizumab in ovarian cancer: a panel of potential biomarkers informing treatment selection. Clin Cancer Res. 2013;19:5227–39.PubMedCentralCrossRefPubMed
13.
go back to reference Mukhopadhyay A. et al. Development of a functional assay for homologous recombination status in primary cultures of epithelial ovarian tumor and correlation with sensitivity to poly(ADP-ribose) polymerase inhibitors. Clin Cancer Res. 2010;16:2344–51.CrossRefPubMed Mukhopadhyay A. et al. Development of a functional assay for homologous recombination status in primary cultures of epithelial ovarian tumor and correlation with sensitivity to poly(ADP-ribose) polymerase inhibitors. Clin Cancer Res. 2010;16:2344–51.CrossRefPubMed
14.
go back to reference Elattar A, et al. Androgen receptor expression is a biological marker for androgen sensitivity in high-grade serous epithelial ovarian cancer. Gynecol Oncol. 2012;124:142–47.CrossRefPubMed Elattar A, et al. Androgen receptor expression is a biological marker for androgen sensitivity in high-grade serous epithelial ovarian cancer. Gynecol Oncol. 2012;124:142–47.CrossRefPubMed
15.
go back to reference Narayanan A, Keedwell E, Olsson B. Artificial intelligence techniques for bioinformatics. Appl. Bioinformat. 2002;1:191–222. Narayanan A, Keedwell E, Olsson B. Artificial intelligence techniques for bioinformatics. Appl. Bioinformat. 2002;1:191–222.
16.
go back to reference Wilkinson SJ, et al. Expression of gonadotrophin releasing hormone receptor I is a favorable prognostic factor in epithelial ovarian cancer. Hum Pathol. 2008;39:1197–204.CrossRefPubMed Wilkinson SJ, et al. Expression of gonadotrophin releasing hormone receptor I is a favorable prognostic factor in epithelial ovarian cancer. Hum Pathol. 2008;39:1197–204.CrossRefPubMed
17.
go back to reference Dziuda D. Data Mining for Genomics and Proteomics: Analysis of Gene and Protein Expression Data. Wiley, New Jersey, 2010.CrossRef Dziuda D. Data Mining for Genomics and Proteomics: Analysis of Gene and Protein Expression Data. Wiley, New Jersey, 2010.CrossRef
18.
go back to reference Cort JW, Kenji M. Advantages of the mean absolute error (MAE) over the root mean square error (RMSE) in assessing average model performance. Climate Res. 2005;30:79–82.CrossRef Cort JW, Kenji M. Advantages of the mean absolute error (MAE) over the root mean square error (RMSE) in assessing average model performance. Climate Res. 2005;30:79–82.CrossRef
19.
go back to reference Bristow RE. Predicting surgical outcome for advanced ovarian cancer, surgical standards of care, and the concept of kaizen. Gynecol Oncol. 2009;112:1–3.CrossRefPubMed Bristow RE. Predicting surgical outcome for advanced ovarian cancer, surgical standards of care, and the concept of kaizen. Gynecol Oncol. 2009;112:1–3.CrossRefPubMed
20.
go back to reference Salani R, et al. Limited utility of conventional criteria for predicting unresectable disease in patients with advanced stage epithelial ovarian cancer. Gynecol Oncol. 2008;108:271–5.CrossRefPubMed Salani R, et al. Limited utility of conventional criteria for predicting unresectable disease in patients with advanced stage epithelial ovarian cancer. Gynecol Oncol. 2008;108:271–5.CrossRefPubMed
21.
go back to reference Jefferson MF, et al. Comparison of a genetic algorithm neural network with logistic regression for predicting outcome after surgery for patients with nonsmall cell lung carcinoma. Cancer. 1997;79:1338–42.CrossRefPubMed Jefferson MF, et al. Comparison of a genetic algorithm neural network with logistic regression for predicting outcome after surgery for patients with nonsmall cell lung carcinoma. Cancer. 1997;79:1338–42.CrossRefPubMed
22.
go back to reference CG Gerestein ME, de Jong D, van der Burg MEL, Dykgraaf RHM, Kooi GS, Baalbergen A, Burger CW, Ansink AC. The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma. BJOG Int J Obstet Gynaecol. 2009;116:372–80.CrossRef CG Gerestein ME, de Jong D, van der Burg MEL, Dykgraaf RHM, Kooi GS, Baalbergen A, Burger CW, Ansink AC. The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma. BJOG Int J Obstet Gynaecol. 2009;116:372–80.CrossRef
Metadata
Title
Artificial Intelligence Systems as Prognostic and Predictive Tools in Ovarian Cancer
Authors
A. Enshaei
C. N. Robson
R. J. Edmondson
Publication date
01-11-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4475-6

Other articles of this Issue 12/2015

Annals of Surgical Oncology 12/2015 Go to the issue