Predicting salvage laryngectomy in patients treated with primary nonsurgical therapy for laryngeal squamous cell carcinoma using machine learning
- 1 September 2020
- journal article
- research article
- Published by Wiley in Head & Neck
- Vol. 42 (9), 2330-2339
- https://doi.org/10.1002/hed.26246
Abstract
Background Machine learning (ML) algorithms may predict patients who will require salvage total laryngectomy (STL) after primary radiotherapy with or without chemotherapy for laryngeal squamous cell carcinoma (SCC). Methods Patients treated for T1-T3a laryngeal SCC were identified from the National Cancer Database. Multiple ML algorithms were trained to predict which patients would go on to require STL after primary nonsurgical treatment. Results A total of 16 440 cases were included. The best classification performance was achieved with a gradient boosting algorithm, which achieved accuracy of 76.0% (95% CI 74.5-77.5) and area under the curve = 0.762. The most important variables used to construct the model were distance from residence to treating facility and days from diagnosis to start of treatment. Conclusion We can identify patients likely to fail primary radiotherapy with or without chemotherapy and who will go on to require STL by applying ML techniques and argue for high-quality, multidisciplinary regionalized care.Keywords
This publication has 71 references indexed in Scilit:
- The impact of comorbidity on the survival of patients with laryngeal squamous cell carcinomaActa Oto-Laryngologica, 2011
- Permutation importance: a corrected feature importance measureBioinformatics, 2010
- The impact of health insurance status on the survival of patients with head and neck cancerCancer, 2009
- Conservation laryngeal surgery versus total laryngectomy for radiation failure in laryngeal cancerHead & Neck, 2006
- Impact of comorbidity on the outcome of laryngeal squamous cancerHead & Neck, 2003
- Salvage Surgery for Patients With Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means?The Laryngoscope, 2000
- Validation of a combined comorbidity indexJournal of Clinical Epidemiology, 1994
- Induction Chemotherapy plus Radiation Compared with Surgery plus Radiation in Patients with Advanced Laryngeal CancerThe New England Journal of Medicine, 1991
- Cancer of the larynx: A new staging system and a re-appraisal of prognosis and treatmentJournal of Chronic Diseases, 1977