Ta期膀胱癌早期再発予測における機械学習手法と従来の統計的手法との比較

Predicting whether recurrence will occur during follow-up in bladder cancer cases confined to the mucosa (Ta-stage) is one of the crucial aspects of management. In this study, we aimed to compare the models obtained by conventional statistical methods and machine learning (ML) methods in order to predict the development of recurrence in the 2-year postoperative period in Ta stage Non-Muscle Invasive Bladder Cancers.

The data of patients who underwent complete transurethral resection of the bladder and were found to have Ta pathologies due to primary bladder cancer between 2018-2021 was retrospectively screened. Patients with no recurrence during the two-year follow-up were classified as Group 1 (N.=107, 58.2%), and those with recurrence were classified as Group 2 (N.=77, 41.8%). The demographic, clinical, imaging and pathological data were recorded. These parameters were analyzed using a conventional statistical method and ML methods to construct prediction models.

Body Mass Index, American Society of Anesthesiologists (ASA) score, and the presence of macroscopic hematuria were found to be significant variables to predict early recurrence (P<0.05). The prediction model created by Cox-regression analysis was determined to have a sensitivity of 65%, specificity of 63.6%, and an area under the curve (AUC) value of 66%, while the AUC values achieved by the ML methods, namely random forest, logistic regression, and k-nearest neighbors, were calculated to be 0.75, 0.87 and 0.74, respectively.

Models developed using ML can provide more accurate predictions than conventional statistical methods in predicting the recurrence of Ta bladder cancer.