Mp55-07 can neuronal network-based machine learning predict pathologically significant prostate cancer in patients diagnosed with gleason grade 6 on pre-operative prostate biopsy

You have accessJournal of UrologyCME1 Apr 2023MP55-07 CAN NEURONAL NETWORK-BASED MACHINE LEARNING PREDICT PATHOLOGICALLY SIGNIFICANT PROSTATE CANCER IN PATIENTS DIAGNOSED WITH GLEASON GRADE 6 ON PRE-OPERATIVE PROSTATE BIOPSY Omri Nativ, Ehud Berger, Kamil Malshy, Omer Sadeh, Alexander Kastin, Alexander Kravtzov, Edmond Sabo, Azik Hoffman, and Gilad Amiel Omri NativOmri Nativ More articles by this author , Ehud BergerEhud Berger More articles by this author , Kamil MalshyKamil Malshy More articles by this author , Omer SadehOmer Sadeh More articles by this author , Alexander KastinAlexander Kastin More articles by this author , Alexander KravtzovAlexander Kravtzov More articles by this author , Edmond SaboEdmond Sabo More articles by this author , Azik HoffmanAzik Hoffman More articles by this author , and Gilad AmielGilad Amiel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003308.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The management of PCa is based on a risk stratification where in the case of localized disease the patients are elected for either active surveillance or an invasive treatment. This risk stratification system is based on three main parameters: PSA level, Gleason grade and the clinical stage of the disease. Despite the clinical definition of a low-risk disease, in certain cases the disease biology is actually aggressive with a potential to become a significant disease or in other cases a sampling error has undegraded the true disease pathology. The aim of our study was to determine the probability of Gleason score upgrading to a clinically significant disease using neuronal network machine learning. METHODS: Using our local radical prostatectomy registry, we have retrospectively reviewed patients' medical records for Age, BMI, PSA level at diagnosis, prostate biopsy findings, prostate volume, PSA-D, D'Amico risk classification, Gleason grade group and pathological staging following prostate biopsy and surgery. Clinically significant (CS) PCa was defined as Gleason 7(3+4) and higher (≥ GG 2). Univariant and multivariant analyses were used to predict significant PCa at radical prostatectomy specimens. Fisher exact and Mann-Whitney U tests were used for categorical and continuous variables, respectively. Next, a neural network (NN) machine learning model was trained using the above variables in order to predict the probability of pathologically upgrading to a CS disease. A back propagation algorithm was used for validation of the NN. RESULTS: 428 patients underwent robotic-assisted radical prostatectomy between 2012 and 2021 in our institution. 72 patients (17%) had a clinically insignificant disease determined by prostate biopsy. of which 34 patients (72%) were upgraded to a CS disease on the final pathology. On univariate and multivariate analysis, the only preoperative variable that predicted a CS final pathology was the PSA-density (PSAD) with a sensitivity and specificity of 36% and 74% respectively. When using the NN machine learning the probability to predict disease upgrading was more accurate with a sensitivity and specificity of 94.1% and 97.1% respectively. CONCLUSIONS: NN machine learning can be trained and used for predicting the probability of PCa upgrading in patients with a biopsy proven Gleason 6 disease. In our cohort the NN sensitivity and specificity were superior compared to the traditional descriptive statistics. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e765 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Omri Nativ More articles by this author Ehud Berger More articles by this author Kamil Malshy More articles by this author Omer Sadeh More articles by this author Alexander Kastin More articles by this author Alexander Kravtzov More articles by this author Edmond Sabo More articles by this author Azik Hoffman More articles by this author Gilad Amiel More articles by this author Expand All Advertisement PDF downloadLoading ...