Researchers have developed an artificial intelligence (AI)–based tool for estimating a newly diagnosed cancer patient’s chances for surviving long term, according to a study presented at the American College of Surgeons (ACS) Clinical Congress 2023.
Currently, estimating survival rates for patients with cancer primarily depends on their cancer stage, said lead study author Lauren Janczewski, MD, a clinical scholar with ACS Cancer Programmes and a general surgical resident at Northwestern University McGaw Medical Centre, Chicago.
“There is a multitude of other factors that may influence a patient’s survival beyond just their staging criteria,” Dr. Janczewski said. “We sought to develop this Cancer Survival Calculator to provide a more personalised estimate of what patients can expect regarding their cancer prognosis.”
Initial tests estimated five-year survival for patients with cancers of the breast, thyroid, and pancreas. The team included data from 259,485 breast cancer patients, 76,624 thyroid cancer patients, and 84,514 pancreatic cancer patients. The researchers found multiple characteristics specific to patients, tumours, and treatments for all three cancer sites significantly influenced survival.
The top four factors influencing whether patients were alive five years after diagnosis were as follows, by cancer site:
- Breast cancer: (1) whether the patient had cancer surgery, (2) the patient’s age at diagnosis, (3) tumour size, and (4) time from diagnosis to treatment.
- Thyroid cancer: (1) age at diagnosis, (2) tumour size, (3) time to treatment, and (4) lymph node involvement.
- Pancreatic cancer: (1) cancer surgery; (2) histology, or microscopic analysis of the cancer, (3) tumour size, and (4) age at diagnosis.
Also found to be important for survival from breast cancer were hormone receptor status, which is part of breast cancer staging, and the presence of Ki-67, a biomarker in breast cancer.
Although some of the predictive factors, such as tumour size, are part of cancer staging, Dr. Janczewski said their results showed that many more factors influence survival for cancer patients beyond their disease stage. Furthermore, their validation testing showed that the calculator was “highly accurate” for all three cancer sites at estimating cancer survival rates – within nine to 10 months of actual survival, Dr. Janczewski reported.
The novel calculator includes specific tumour biomarkers and treatment variables that are known to affect a patient’s estimated prognosis, which Dr. Janczewski said many prior survival calculators lack. The next steps that Dr. Janczewski identified are to finalise a user interface that will allow the use of the Cancer Survival Calculator in clinical practice, followed by pilot testing the calculator at selected cancer centres.
Reference
Janczewski L, et al. Development of a National Cancer Survival Calculator Prototype Using Machine Learning, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2023.
