Framework for a Computer-Aided Treatment Prediction (CATP) System for Breast Cancer

This study offers a framework for a breast cancer computer-aided treat-ment prediction(CATP)system.The rising death rate among women due to breast cancer is a worldwide health concern that can only be addressed by early diagno-sis and frequent screening.Mammography has been the most utilized breast ima-ging technique to date.Radiologists have begun to use computer-aided detection and diagnosis(CAD)systems to improve the accuracy of breast cancer diagnosis by minimizing human errors.Despite the progress of artificial intelligence(AI)in the medical field,this study indicates that systems that can anticipate a treatment plan once a patient has been diagnosed with cancer are few and not widely used.Having such a system will assist clinicians in determining the optimal treatment plan and avoid exposing a patient to unnecessary hazardous treatment that wastes a significant amount of money.To develop the prediction model,data from 336,525 patients from the SEER dataset were split into training(80%),and testing(20%)sets.Decision Trees,Random Forest,XGBoost,and CatBoost are utilized with feature importance to build the treatment prediction model.The best overall Area Under the Curve(AUC)achieved was 0.91 using Random Forest on the SEER dataset.

Ⅳ期结直肠癌不同手术策略对患者预后的影响

目的Ⅳ期结直肠癌患者的预后较差,手术策略的选择对Ⅳ期结直肠癌患者一直存有争议,本研究拟通过大数据样本系统评估Ⅳ期结直肠癌不同手术策略对患者预后的影响。方法通过筛选,从美国国家癌症研究所的监测、流行病学和最终结果数据库(National Cancer Institute′s Surveillance,Epidemiology,and End Results dataset,SEER)中获得13077例2010~2015年诊断为Ⅳ期结直肠癌的患者信息。将获取的数据分为以下四组:均未手术组、原发手术组、转移手术组、均行手术组,分析四种手术策略的患者预后情况,并进一步探究化疗与否对手术策略的疗效影响。结果四个研究组均获得中位生存时间,分别为11、18、20、31个月(P<0.001)。COX多因素分析表明,相比于均未手术组,原发手术组、转移手术组、均行手术组患者预后更好,HR分别为0.640(95%CI:0.605~0.677;P<0.001)、0.592(95%CI:0.424~0.828;P=0.002)、0.371(95%CI:0.343~0.401;P<0.001)。在无(未知)进行化疗的患者中,均行手术组患者(MST=6个月)预后好于原发手术组患者(MST=5个月;P<0.001);转移手术组患者(MST=4个月)预后与均未手术组患者(MST=2个月;P=0.236)相似。在进行化疗的患者中得到不同的结果,均行手术组患者(MST=36个月)预后好于原发手术组患者(MST=25个月;P<0.001);而转移手术组患者(MST=22个月)预后好于均未手术组患者(MST=16个月;P=0.015),并且化疗患者(MST=25个月)预后明显好于无(未知)化疗患者(MST=4个月;P<0.001)。结论Ⅳ期结直肠癌手术治疗患者与未进行手术患者相比,具有更好的生存获益情况。化疗因素也会影响患者的预后情况,在无(未知)化疗的患者中,应避免单一转移部位手术;而经历化疗的患者中,转移性肿瘤的切除可以获得更好的获益情况。同时进一步证明了化疗对Ⅳ期结直肠癌患者的疗效。