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Article

Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders

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Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China
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Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China
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Department of Pathology, Queen Mary Hospital, Hong Kong 999077, China
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Division of Otorhinolaryngology, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
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Division of Head and Neck Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
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College of Medicine and Dentistry, James Cook University, Cairns, QLD 4870, Australia
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Authors to whom correspondence should be addressed.
Academic Editors: Pierre Saintigny, Senada Koljenović, Paolo Bossi and Jebrane Bouaoud
Cancers 2021, 13(23), 6054; https://doi.org/10.3390/cancers13236054
Received: 8 November 2021 / Revised: 26 November 2021 / Accepted: 26 November 2021 / Published: 1 December 2021
(This article belongs to the Special Issue Personalized Preventive Medicine of Oral Cancer)
Mouth cancer is the most common malignancy in the head-and-neck region. Usually, these tumors develop from white lesions in the mouth that appear long before cancer diagnosis. However, platforms that can estimate the time-factored risk of cancer occurring from these diseases and guide treatment and monitoring approaches are elusive. To this end, our study presents time-to-event models that are based on machine learning for prediction of the risk of malignancy from oral white lesions following pathological diagnosis as a function of time. These models displayed very satisfactory discrimination and calibration after multiple tests. To facilitate their preliminary use in clinical practice and further validation, we created a website supporting the use of these models to aid decision making.
Machine-intelligence platforms for the prediction of the probability of malignant transformation of oral potentially malignant disorders are required as adjunctive decision-making platforms in contemporary clinical practice. This study utilized time-to-event learning models to predict malignant transformation in oral leukoplakia and oral lichenoid lesions. A total of 1098 patients with oral white lesions from two institutions were included in this study. In all, 26 features available from electronic health records were used to train four learning algorithms—Cox-Time, DeepHit, DeepSurv, random survival forest (RSF)—and one standard statistical method—Cox proportional hazards model. Discriminatory performance, calibration of survival estimates, and model stability were assessed using a concordance index (c-index), integrated Brier score (IBS), and standard deviation of the averaged c-index and IBS following training cross-validation. This study found that DeepSurv (c-index: 0.95, IBS: 0.04) and RSF (c-index: 0.91, IBS: 0.03) were the two outperforming models based on discrimination and calibration following internal validation. However, DeepSurv was more stable than RSF upon cross-validation. External validation confirmed the utility of DeepSurv for discrimination (c-index—0.82 vs. 0.73) and RSF for individual survival estimates (0.18 vs. 0.03). We deployed the DeepSurv model to encourage incipient application in clinical practice. Overall, time-to-event models are successful in predicting the malignant transformation of oral leukoplakia and oral lichenoid lesions. View Full-Text
Keywords: artificial intelligence; machine learning; oral leukoplakia; oral lichenoid lesions; oral cancer artificial intelligence; machine learning; oral leukoplakia; oral lichenoid lesions; oral cancer
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MDPI and ACS Style

Adeoye, J.; Koohi-Moghadam, M.; Lo, A.W.I.; Tsang, R.K.-Y.; Chow, V.L.Y.; Zheng, L.-W.; Choi, S.-W.; Thomson, P.; Su, Y.-X. Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders. Cancers 2021, 13, 6054. https://doi.org/10.3390/cancers13236054

AMA Style

Adeoye J, Koohi-Moghadam M, Lo AWI, Tsang RK-Y, Chow VLY, Zheng L-W, Choi S-W, Thomson P, Su Y-X. Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders. Cancers. 2021; 13(23):6054. https://doi.org/10.3390/cancers13236054

Chicago/Turabian Style

Adeoye, John, Mohamad Koohi-Moghadam, Anthony Wing Ip Lo, Raymond King-Yin Tsang, Velda Ling Yu Chow, Li-Wu Zheng, Siu-Wai Choi, Peter Thomson, and Yu-Xiong Su. 2021. "Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders" Cancers 13, no. 23: 6054. https://doi.org/10.3390/cancers13236054

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