Creating prognostic systems for cancer patients: A demonstration using breast cancer

Abstract Integrating additional prognostic factors into the tumor, lymph node, metastasis staging system improves the relative stratification of cancer patients and enhances the accuracy in planning their treatment options and predicting clinical outcomes. We describe a novel approach to build progn...

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Main Authors: Mathew T. Hueman, Huan Wang, Charles Q. Yang, Li Sheng, Donald E. Henson, Arnold M. Schwartz, Dechang Chen
Format: Article
Language:English
Published: Wiley 2018-08-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.1629
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author Mathew T. Hueman
Huan Wang
Charles Q. Yang
Li Sheng
Donald E. Henson
Arnold M. Schwartz
Dechang Chen
author_facet Mathew T. Hueman
Huan Wang
Charles Q. Yang
Li Sheng
Donald E. Henson
Arnold M. Schwartz
Dechang Chen
author_sort Mathew T. Hueman
collection DOAJ
description Abstract Integrating additional prognostic factors into the tumor, lymph node, metastasis staging system improves the relative stratification of cancer patients and enhances the accuracy in planning their treatment options and predicting clinical outcomes. We describe a novel approach to build prognostic systems for cancer patients that can admit any number of prognostic factors. In the approach, an unsupervised learning algorithm was used to create dendrograms and the C‐index was used to cut dendrograms to generate prognostic groups. Breast cancer data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute were used for demonstration. Two relative prognostic systems were created for breast cancer. One system (7 prognostic groups with C‐index = 0.7295) was based on tumor size, regional lymph nodes, and no distant metastasis. The other system (7 prognostic groups with C‐index = 0.7458) was based on tumor size, regional lymph nodes, no distant metastasis, grade, estrogen receptor, progesterone receptor, and age. The dendrograms showed a relationship between survival and prognostic factors. The proposed approach is able to create prognostic systems that have a good accuracy in survival prediction and provide a manageable number of prognostic groups. The prognostic systems have the potential to permit a thorough database analysis of all information relevant to decision‐making in patient management and prognosis.
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spelling doaj-art-f2469ca7bbb0421a9a01cd9adb59ef912024-12-20T13:15:44ZengWileyCancer Medicine2045-76342018-08-01783611362110.1002/cam4.1629Creating prognostic systems for cancer patients: A demonstration using breast cancerMathew T. Hueman0Huan Wang1Charles Q. Yang2Li Sheng3Donald E. Henson4Arnold M. Schwartz5Dechang Chen6Department of Surgical Oncology John P. Murtha Cancer Center Walter Reed National Military Medical Center Bethesda MD USADepartment of Biostatistics The George Washington University Washington DC USADepartment of Surgery Walter Reed National Military Medical Center Bethesda MD USADepartment of Mathematics Drexel University Philadelphia PA USADepartment of Preventive Medicine & Biostatistics F. Edward Hébert School of Medicine Uniformed Services University of the Health Sciences Bethesda MD USADepartment of Pathology School of Medicine and Health Sciences The George Washington University Washington DC USADepartment of Preventive Medicine & Biostatistics F. Edward Hébert School of Medicine Uniformed Services University of the Health Sciences Bethesda MD USAAbstract Integrating additional prognostic factors into the tumor, lymph node, metastasis staging system improves the relative stratification of cancer patients and enhances the accuracy in planning their treatment options and predicting clinical outcomes. We describe a novel approach to build prognostic systems for cancer patients that can admit any number of prognostic factors. In the approach, an unsupervised learning algorithm was used to create dendrograms and the C‐index was used to cut dendrograms to generate prognostic groups. Breast cancer data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute were used for demonstration. Two relative prognostic systems were created for breast cancer. One system (7 prognostic groups with C‐index = 0.7295) was based on tumor size, regional lymph nodes, and no distant metastasis. The other system (7 prognostic groups with C‐index = 0.7458) was based on tumor size, regional lymph nodes, no distant metastasis, grade, estrogen receptor, progesterone receptor, and age. The dendrograms showed a relationship between survival and prognostic factors. The proposed approach is able to create prognostic systems that have a good accuracy in survival prediction and provide a manageable number of prognostic groups. The prognostic systems have the potential to permit a thorough database analysis of all information relevant to decision‐making in patient management and prognosis.https://doi.org/10.1002/cam4.1629breast cancercancer stagingC‐indexdendrogrammachine learningsurvival
spellingShingle Mathew T. Hueman
Huan Wang
Charles Q. Yang
Li Sheng
Donald E. Henson
Arnold M. Schwartz
Dechang Chen
Creating prognostic systems for cancer patients: A demonstration using breast cancer
Cancer Medicine
breast cancer
cancer staging
C‐index
dendrogram
machine learning
survival
title Creating prognostic systems for cancer patients: A demonstration using breast cancer
title_full Creating prognostic systems for cancer patients: A demonstration using breast cancer
title_fullStr Creating prognostic systems for cancer patients: A demonstration using breast cancer
title_full_unstemmed Creating prognostic systems for cancer patients: A demonstration using breast cancer
title_short Creating prognostic systems for cancer patients: A demonstration using breast cancer
title_sort creating prognostic systems for cancer patients a demonstration using breast cancer
topic breast cancer
cancer staging
C‐index
dendrogram
machine learning
survival
url https://doi.org/10.1002/cam4.1629
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