Bayesian network structure for predicting local tumor recurrence in rectal cancer patients treated with neoadjuvant chemoradiation followed by surgery
Physics and Imaging in Radiation Oncology, vol. 22, pp. 1–7
Abstract
Background and Purpose: Tumor recurrence, a characteristic of malignant tumors, is the biggest concern for rectal cancer survivors. The epidemiology of the disease calls for a pressing need to improve healthcare quality and patient outcomes. Prediction models such as Bayesian networks, which can probabilistically reason under uncertainty, could assist caregivers with patient management. However, some concerns are associated with the standard approaches to developing these structures in medicine. Therefore, this study aims to compare Bayesian network structures that stem from these two techniques. Patients and Methods: A retrospective analysis was performed on 6754 locally advanced rectal cancer (LARC) patients enrolled in 14 international clinical trials. Local tumor recurrence at 2, 3, and 5-years was defined as the endpoints of interest. Five rectal cancer treating physicians from three countries elicited the expert structure. The algorithmic structure was inferred from the data with the hill-climbing algorithm. Structural performance was assessed with calibration plots and area under the curve values. Results: The area under the curve for the expert structure on the training and validation data was above 0.9 and 0.8, respectively, for all the time points. However, the algorithmic structure had superior predictive performance over the expert structure for all time points of interest. Conclusion: We have developed and internally validated a Bayesian networks structure from experts' opinions, which can predict the risk of a LARC patient developing a tumor recurrence at 2, 3, and 5 years. Our result shows that the algorithmic-based structures are more performant and less interpretable than expert-based structures.
Authors 21
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Biche Osong corresponding
Maastricht University Medical Centre · Maastricht University · Maastro Clinic
Affiliation as printed
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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Agostino Gemelli University Polyclinic
Affiliation as printed
Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Università Cattolica del Sacro Cuore
Affiliation as printed
Universita Cattolica del Sacro Cuore, Roma, Italy
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Maastricht University Medical Centre · Maastricht University · Maastro Clinic
Affiliation as printed
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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Agostino Gemelli University Polyclinic
Affiliation as printed
Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Agostino Gemelli University Polyclinic
Affiliation as printed
Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Maastricht University Medical Centre · Maastricht University · Maastro Clinic
Affiliation as printed
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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Gachon University · Gachon University Gil Medical Center
Affiliation as printed
Department of Radiation Oncology, Gachon University, College of Medicine, Gil Medical Center, Incheon, South Korea
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Maastricht University Medical Centre · Maastricht University · Maastro Clinic
Affiliation as printed
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic
Affiliation as printed
Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
Universita Cattolica del Sacro Cuore, Roma, Italy
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Affiliation as printed
Department of Radiotherapy, Centre Antoine-Lacassagne, Nice, France
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Affiliation as printed
Department of Radiotherapy, University of Frankfurt, Germany
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The Maria Sklodowska-Curie National Research Institute of Oncology
Affiliation as printed
Department of Radiotherapy I, M. Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Center, The Netherlands
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Affiliation as printed
Department of Surgery, Uppsala University Hospital, Uppsala, Sweden
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Affiliation as printed
Department of Radiotherapy, Pisa University, Italy
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Affiliation as printed
Department of Radiotherapy, Mount Vernon Cancer Centre, Northwood, United Kingdom
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Affiliation as printed
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Affiliation as printed
Department of Oncology, Oslo University Hospital, Oslo, Norway
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Affiliation as printed
Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
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Maastricht University Medical Centre · Maastricht University · Maastro Clinic
Affiliation as printed
Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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