Use of machine learning to predict bladder cancer survival outcomes: a systematic literature review

Abstract

Introduction: The objective of this systematic review is to summarize the use of machine learning (ML) in predicting overall survival (OS) in patients with bladder cancer.

Methods: Search terms for bladder cancer, ML algorithms, and mortality were used to identify studies in PubMed and Web of Science as of February 2022. Notable inclusion/exclusion criteria contained the inclusion of studies that utilized patient-level datasets and exclusion of primary gene expression-related dataset studies. Study quality and bias were assessed using the International Journal of Medical Informatics (IJMEDI) checklist.

Results: Of the 14 included studies, the most common algorithms were artificial neural networks (n = 8) and logistic regression (n = 4). Nine articles described missing data handling, with five articles removing patients with missing data entirely. With respect to feature selection, the most common sociodemographic variables were age (n = 9), gender (n = 9), and smoking status (n = 3), with clinical variables most commonly including tumor stage (n = 8), grade (n = 7), and lymph node involvement (n = 6). Most studies (n = 10) were of medium IJMEDI quality, with common areas of improvement being the descriptions of data preparation and deployment.

Conclusions: ML holds promise for optimizing bladder cancer care through accurate OS predictions, but challenges related to data processing, feature selection, and data source quality must be resolved to develop robust models. While this review is limited by its inability to compare models across studies, this systematic review will inform decision-making by various stakeholders to improve understanding of ML-based OS prediction in bladder cancer and foster interpretability of future models.

Keywords: bladder cancer; machine learning; oncology; survival outcomes; systematic review.