Artificial neural network model for the assessment of lymph node spread in patients with clinically localized prostate cancer

Joseph T. Batuello, Eduard J. Gamito, E. David Crawford, Misop Han, Alan W. Partin, David G. McLeod, Colin O'Donnell

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Objectives. To develop an artificial neural network (ANN) model to predict lymph node (LN) spread in men with clinically localized prostate cancer and to describe a clinically useful method for interpreting the ANN's output scores. Methods. A simple, feed-forward ANN was trained and validated using clinical and pathologic data from two institutions (n = 6135 and n = 319). The clinical stage, biopsy Gleason sum, and prostate-specific antigen level were the input parameters and the presence or absence of LN spread was the output parameter. Patients with similar ANN outputs were grouped and assumed to be part of a cohort. The prevalence of LN spread for each of these patient cohorts was plotted against the range of ANN outputs to create a risk curve. Results. The area under the receiver operating characteristic curve for the first and second validation data sets was 0.81 and 0.77, respectively. At an ANN output cutoff of 0.3, the sensitivity achieved for each validation set was 63.8% and 44.4%; the specificity was 81.5% and 81.3%; the positive predictive value was 13.6% and 6.5%; and the negative predictive value was 98.0% and 98.1%, respectively. The risk curve showed a nearly linear increase (best fit R 2 = 0.972) in the prevalence of LN spread with increases in raw ANN output. Conclusions. The ANN's performance on the two validation data sets suggests a role for ANNs in the accurate clinical staging of patients with prostate cancer. The risk curve provides a clinically useful tool that can be used to give patients a realistic assessment of their risk of LN spread.

Original languageEnglish (US)
Pages (from-to)481-485
Number of pages5
Issue number3
StatePublished - 2001

ASJC Scopus subject areas

  • Urology


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