Development and validation of hybrid machine learning approach for predicting survival in patients with cervical...

Accurate survival prediction in cervical cancer is crucial for personalized therapy, particularly in high-risk groups where early intervention might enhance results. The study aims to create a hybrid survival model that integrates Cox Proportional Hazards (CoxPH) with Elastic Net regularization and Random Survival Forest (RSF) to improve prediction accuracy and interpretability.

Data from the SEER database (2013-2015) were pre-processed through normalization and encoding. RSF recorded non-linear interactions between covariates, while the CoxPH Elastic Net Regularization model provided linear interpretability and identified key variables. Model parameters were optimized using cross-validation, and final performance was assessed on an independent test set using metrics including C-index, Integrated Brier Score (IBS), AUC-ROC, and calibration plots.

The hybrid model outperformed the individual models with an Integrated Brier Score (IBS) of 0.13 and a concordance index (C-index) of 0.82. With an AUC-ROC of 0.84, the model provided robust calibration and classification performance on the independent test set, effectively separating between individuals at high and low risk.

The hybrid model provides a promising tool for personalized risk stratification in cervical cancer based on survival probability. Further testing in varied clinical categories is recommended to confirm its efficiency in precision oncology.