Predicting hepatocellular carcinoma recurrences: A data-driven multiclass classification method incorporating latent variables

J Biomed Inform. 2019 Aug:96:103237. doi: 10.1016/j.jbi.2019.103237. Epub 2019 Jun 22.

Abstract

Hepatocellular carcinoma (HCC), a malignant form of cancer, is frequently treated with surgical resections, which have relatively high recurrence rates. Effective recurrence predictions enable physicians' timely detections and adequate therapeutic measures that can greatly improve patient care and outcomes. Toward that end, predictions of early versus late HCC recurrences should be considered separately to reflect their distinct onset time horizons, clinical causes, underlying clinical etiology, and pathogenesis. We propose a novel Bayesian network-based method to predict different HCC recurrence outcomes by considering the respective recurrence evolution paths. Typical patient information obtained in early stages is insufficiently informative to predict recurrence outcomes accurately, due to the lack of subsequent patient progression information. Our method alleviates such information deficiency constraints by incorporating an independent latent variable, dominant recurrence type, to regulate recurrence outcome predictions (early, late, or no recurrence). We use a real-world HCC data set to evaluate the proposed method, relative to three prevalent benchmark techniques. Overall, the results show that our method consistently and significantly outperforms all the benchmark techniques in terms of accuracy, precision, recall, and F-measures. For increased robustness, we use another data set to perform an out-of-sample evaluation and obtain similar results. This study thus contributes to HCC recurrence research and offers several implications for clinical practice.

Keywords: Bayesian network; Clinical decision support; Hepatocellular carcinoma recurrence; Machine learning; Predictive analytics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bayes Theorem
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery
  • Child
  • Databases, Factual
  • Decision Support Systems, Clinical
  • Female
  • Humans
  • Latent Class Analysis
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery
  • Machine Learning
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Risk Factors
  • Taiwan / epidemiology
  • Treatment Outcome
  • Young Adult