Machine Learning to Predict Postradical Prostatectomy Pathology Outcomes in Intermediate Risk Prostate Cancer

Abstract

Purpose/Objective(s): Although rare, the incidence of bilateral testicular germ cell tumors (GCTs) has increased over time. Using the Surveillance, Epidemiology, and End Results (SEER) database, we describe the prevalence, characteristics, and outcomes of bilateral testicular GCTs, as well as the impact of prior radiotherapy on development of a metachronous GCT. Materials/Methods: A total of 757 cases of bilateral and 42,713 cases of unilateral testicular GCTs treated 1973-2013 were identified in the SEER database. Descriptive statistics are presented. Differences between unilateral and bilateral tumors were analyzed using the chi-square test. The risk of metachronous GCT was calculated using multivariable Cox proportional hazards regression models. Results: The percentage of bilaterality among all men with testicular GCTs was 1.7% (757/43,470). Of the 757 bilateral GCTs, 29% (nZ219) occurred synchronously (Table). Mean age at diagnosis was 34 years for men with unilateral GCT, 33 years for men with synchronous bilateral, and 30 and 35 years for men with asynchronous bilateral GCTs (first and second diagnoses, respectively). For asynchronous tumors, the median time between diagnoses was 5 years (range, 0.1-29.9 years). Among synchronous GCTs, 42% (92/219) were concordant seminomas, 10% (22/ 219) were concordant non-seminomas, and 48% (105/219) were discordant histologies. Among asynchronous GCTs, 42% (227/538) were concordant seminomas, 19% (104/538) were concordant non-seminomas, and 39% (206/538) were discordant histologies. Testicular cancer was the cause of death for 4.2% of men with a unilateral GCT and 1.1% of men with bilateral GCTs (p <0.001); 6 of the 8 men with bilateral GCTs who died had synchronous tumors. A second malignant neoplasm (SMN) was the cause of death for 1.1% of men with a unilateral and 2.9% of men with bilateral GCTs; among the latter, 7 of the 22 SMN deaths were in synchronous cases. Receipt of radiotherapy was not associated with the risk of developing a metachronous GCT (HR 1.00; 95% CI 0.78-1.27); however, seminoma histology of the first tumor was associated with a 36% increased risk of a metachronous GCT (HR 1.36; 95% CI 1.05-1.75). Conclusion: Among men with bilateral testicular germ cell tumors, two-thirds were diagnosed asynchronously, and most had concordant histologies between their first and second tumors. Men with bilateral testicular GCTs did not have a higher risk of death due to testicular cancer or a subsequent non-germ cell SMN than men with a unilateral testicular GCT. Receipt of radiotherapy did not increase the risk for development of a metachronous testicular GCT.

Prostate cancer classification with multiparametric MRI transfer learning model

“…This research work focused on prostate cancer classification. Since the prediction of disease‐free survival is the ultima goal in clinical trial, we will further collect data and develop suitable models for survival prediction to promote the deep learning‐based radiomics.…”