AUTHOR=Yang Xiaoyan , Yu Wei , Yang Feimin , Cai Xiujun TITLE=Machine learning algorithms to predict atypical metastasis of colorectal cancer patients after surgical resection JOURNAL=Frontiers in Surgery VOLUME=9 YEAR=2023 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1049933 DOI=10.3389/fsurg.2022.1049933 ISSN=2296-875X ABSTRACT=Background

The prognosis of colorectal cancer with atypical metastasis is poor. However, atypical metastasis was less common and under-appreciated.

Methods

In this study we attempted to present the first machine learning models to predict the risk of atypical metastasis in colorectal cancer patients. We evaluated the differences between metastasis and non-metastasis groups, assessed factors associated with atypical metastasis using univariate and multivariate logistic regression analyses, and preliminarily developed the multiple machine learning models to predict atypical metastasis.

Results

168 patients were included. Prognostic Nutritional Index (PNI) [OR =  0.998; P = 0.030], Cancer antigen 19–9 (CA19-9) [OR = 1.011; P = 0.043] and MR-Distance [-mid OR = 0.289; P = 0.009] [-high OR = 0.248; P = 0.021] were shown to be independent risk factors for the atypical metastasis via multivariate analysis. Furthermore, the machine learning model based on AdaBoost algorithm (AUC: 0736) has better predictive performance comparing to Logistic Regression (AUC: 0.671) and KNeighbors Classifier (AUC: 0.618) by area under the curve (AUC) in the validation cohorts. The accuracy, sensitivity, and specificity of the model trained using the Adaboost method in the validation set are 0.786, 0.776 and 0.700, while 0.601, 0.933, 0.508 using Logistic Regression and 0.743, 0.390, 0.831 using KNeighbors Classifier.

Conclusion

Machine-learning approaches containing PNI, CA19-9 and MR-Distance show great potentials in atypical metastasis prediction.