Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery
Abstract Objectives Renal cell carcinoma (RCC) is shown to have a tendency for late recurrence, occurring 5 or more years after curative surgery. Imaging diagnosis is required for follow‐up, and there is no definitive answer as to how long this should continue. Some patients discontinue follow‐up vi...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.425 |
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| author | Kodai Sato Tomokazu Sazuka Takayuki Arai Hiroaki Sato Manato Kanesaka Keisuke Ando Shinpei Saito Sangjon Pae Yasutaka Yamada Yusuke Imamura Shinichi Sakamoto Tomohiko Ichikawa |
| author_facet | Kodai Sato Tomokazu Sazuka Takayuki Arai Hiroaki Sato Manato Kanesaka Keisuke Ando Shinpei Saito Sangjon Pae Yasutaka Yamada Yusuke Imamura Shinichi Sakamoto Tomohiko Ichikawa |
| author_sort | Kodai Sato |
| collection | DOAJ |
| description | Abstract Objectives Renal cell carcinoma (RCC) is shown to have a tendency for late recurrence, occurring 5 or more years after curative surgery. Imaging diagnosis is required for follow‐up, and there is no definitive answer as to how long this should continue. Some patients discontinue follow‐up visits at their own discretion. How best to predict late recurrence and loss to follow‐up (LF) remains unclear. Patients and methods This study targeted patients diagnosed with non‐metastatic RCC who underwent either radical or partial nephrectomy at Chiba University Hospital between 1988 and 2021. Follow‐up for patients with RCC is typically lifelong. We used random survival forests (RSFs), a machine learning‐based survival analysis method, to predict late recurrence and LF. For verification of prediction accuracy, we applied the time‐dependent area under the receiver operating characteristic curve (t‐AUC). To analyse the risks of late recurrence and LF, SurvSHAP(t) and partial dependence plots were used. Results We analysed 1051 cases in this study. Median follow‐up was 58.5 (range: 0–376) months. The predictive accuracy of recurrence using RSF was t‐AUC 0.806, 0.761, 0.674 and 0.566 at 60, 120, 180 and 240 months postoperatively, respectively. The recurrence risk impact showed a time‐dependent increase up to approximately 50 months postoperatively. Beyond 50 months, there were no distinct risk factors characteristic of late recurrence. The predictive accuracy of LF using RSF was t‐AUC 0.542, 0.699, 0.685, 0.628 and 0.674 at 60, 120, 180, 240 and 300 months postoperatively, respectively. The risk of LF increased with advancing age beyond 70 years. Conclusion It is difficult to identify factors that predict late recurrence. For long‐term follow‐up observation, it is essential to pay particular attention to patients with RCC aged 70 years and above. Establishing frameworks to facilitate collaboration with local hospitals near patients' residences and providing care within the community is necessary. |
| format | Article |
| id | doaj-art-b275577542f14d42916a6fbdce0eb5a3 |
| institution | Kabale University |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj-art-b275577542f14d42916a6fbdce0eb5a32024-12-24T02:30:44ZengWileyBJUI Compass2688-45262024-10-015101064107010.1002/bco2.425Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgeryKodai Sato0Tomokazu Sazuka1Takayuki Arai2Hiroaki Sato3Manato Kanesaka4Keisuke Ando5Shinpei Saito6Sangjon Pae7Yasutaka Yamada8Yusuke Imamura9Shinichi Sakamoto10Tomohiko Ichikawa11Department of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology, Graduate School of Medicine Chiba University Chiba JapanAbstract Objectives Renal cell carcinoma (RCC) is shown to have a tendency for late recurrence, occurring 5 or more years after curative surgery. Imaging diagnosis is required for follow‐up, and there is no definitive answer as to how long this should continue. Some patients discontinue follow‐up visits at their own discretion. How best to predict late recurrence and loss to follow‐up (LF) remains unclear. Patients and methods This study targeted patients diagnosed with non‐metastatic RCC who underwent either radical or partial nephrectomy at Chiba University Hospital between 1988 and 2021. Follow‐up for patients with RCC is typically lifelong. We used random survival forests (RSFs), a machine learning‐based survival analysis method, to predict late recurrence and LF. For verification of prediction accuracy, we applied the time‐dependent area under the receiver operating characteristic curve (t‐AUC). To analyse the risks of late recurrence and LF, SurvSHAP(t) and partial dependence plots were used. Results We analysed 1051 cases in this study. Median follow‐up was 58.5 (range: 0–376) months. The predictive accuracy of recurrence using RSF was t‐AUC 0.806, 0.761, 0.674 and 0.566 at 60, 120, 180 and 240 months postoperatively, respectively. The recurrence risk impact showed a time‐dependent increase up to approximately 50 months postoperatively. Beyond 50 months, there were no distinct risk factors characteristic of late recurrence. The predictive accuracy of LF using RSF was t‐AUC 0.542, 0.699, 0.685, 0.628 and 0.674 at 60, 120, 180, 240 and 300 months postoperatively, respectively. The risk of LF increased with advancing age beyond 70 years. Conclusion It is difficult to identify factors that predict late recurrence. For long‐term follow‐up observation, it is essential to pay particular attention to patients with RCC aged 70 years and above. Establishing frameworks to facilitate collaboration with local hospitals near patients' residences and providing care within the community is necessary.https://doi.org/10.1002/bco2.425late recurrenceloss to follow‐upmachine learningrandom survival forestsrenal cell carcinoma |
| spellingShingle | Kodai Sato Tomokazu Sazuka Takayuki Arai Hiroaki Sato Manato Kanesaka Keisuke Ando Shinpei Saito Sangjon Pae Yasutaka Yamada Yusuke Imamura Shinichi Sakamoto Tomohiko Ichikawa Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery BJUI Compass late recurrence loss to follow‐up machine learning random survival forests renal cell carcinoma |
| title | Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery |
| title_full | Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery |
| title_fullStr | Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery |
| title_full_unstemmed | Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery |
| title_short | Machine learning analysis for detecting late recurrence and loss to follow‐up after renal cell carcinoma surgery |
| title_sort | machine learning analysis for detecting late recurrence and loss to follow up after renal cell carcinoma surgery |
| topic | late recurrence loss to follow‐up machine learning random survival forests renal cell carcinoma |
| url | https://doi.org/10.1002/bco2.425 |
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