Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm

Objective‍ ‍To investigate the prognostic factors affecting survival in patients with natural killer T-cell lymphoma (NKTL), and then develop a prognostic model for predicting their overall survival (OS) based on random survival forest (RSF) algorithm. Methods‍ ‍Demographic and clinical pathological...

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Main Authors: HUANG Zhen, WU Yazhou
Format: Article
Language:zho
Published: Editorial Office of Journal of Army Medical University 2025-02-01
Series:陆军军医大学学报
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Online Access:https://aammt.tmmu.edu.cn/html/202410090.html
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author HUANG Zhen
HUANG Zhen
WU Yazhou
author_facet HUANG Zhen
HUANG Zhen
WU Yazhou
author_sort HUANG Zhen
collection DOAJ
description Objective‍ ‍To investigate the prognostic factors affecting survival in patients with natural killer T-cell lymphoma (NKTL), and then develop a prognostic model for predicting their overall survival (OS) based on random survival forest (RSF) algorithm. Methods‍ ‍Demographic and clinical pathological data of NKTL patients were collected from the SEER database during 2000 and 2020. The patients were divided into a training cohort (n=471) and a validation cohort (n=203) in a 7∶3 ratio. Cox regression analysis was performed to identify prognostic factors affecting OS, and a nomogram model was constructed based on the obtained factors. Meanwhile, RSF algorithm was used to determine prognostic factors affecting OS to build the RSF model. The models were evaluated using receiver operating characteristic (ROC) curve, calibration curve, decision curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI), and the predictive performances of the 2 models were compared. Risk scores for each patient were calculated using the 2 models. Then the patients were divided into high- and low-risk groups based on the median risk score, and survival curve was plotted for comparison. Results‍ ‍Ann Arbor stage, age, radiotherapy, combined treatment, and type of disease were identified as significant prognostic variables associated with OS. In the validation cohort, the area under the ROC curve (AUC) for the nomogram model at 1, 3, and 5 years was 0.745, 0.771, and 0.748, respectively, while the AUC for the RSF model was 0.764, 0.792, and 0.761 at the same time points. ROC curve analysis indicated that both models demonstrated good accuracy and discrimination in predicting OS. Calibration curve analysis showed a strong consistency between the predicted and actual OS for both models. Both models effectively stratified the patients into poor and favorable prognosis groups, with the OS of patients in the poor prognosis group being significantly shorter than that of the favorable prognosis group (P<0.000 1). Decision curve analysis revealed that the net benefit of the RSF model was superior to that of the nomogram model. Compared to the nomogram model, the NRI for the RSF model was 0.184 (95%CI: 0.098~0.267, P<0.01), and the IDI was 0.300 (95%CI: 0.241~0.359, P<0.01). Overall, the RSF model demonstrated superior predictive capability than the nomogram model. Conclusion‍ ‍Ann Arbor stage, age, radiotherapy, combined treatment, and type of disease are prognostic factors affecting the prognosis of NKTL patients. Our RSF model demonstrates strong predictive capability for the prognosis of NKTL patients and can effectively assess patient outcomes.
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spelling doaj-art-6423b1ef15c244a495a5b7cf9f794d242025-02-10T01:19:44ZzhoEditorial Office of Journal of Army Medical University陆军军医大学学报2097-09272025-02-0147327528410.16016/j.2097-0927.202410090Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithmHUANG Zhen 0HUANG Zhen 1WU Yazhou2Department of Health Statistics, Faculty of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaCenter for Hematology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Health Statistics, Faculty of Military Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaObjective‍ ‍To investigate the prognostic factors affecting survival in patients with natural killer T-cell lymphoma (NKTL), and then develop a prognostic model for predicting their overall survival (OS) based on random survival forest (RSF) algorithm. Methods‍ ‍Demographic and clinical pathological data of NKTL patients were collected from the SEER database during 2000 and 2020. The patients were divided into a training cohort (n=471) and a validation cohort (n=203) in a 7∶3 ratio. Cox regression analysis was performed to identify prognostic factors affecting OS, and a nomogram model was constructed based on the obtained factors. Meanwhile, RSF algorithm was used to determine prognostic factors affecting OS to build the RSF model. The models were evaluated using receiver operating characteristic (ROC) curve, calibration curve, decision curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI), and the predictive performances of the 2 models were compared. Risk scores for each patient were calculated using the 2 models. Then the patients were divided into high- and low-risk groups based on the median risk score, and survival curve was plotted for comparison. Results‍ ‍Ann Arbor stage, age, radiotherapy, combined treatment, and type of disease were identified as significant prognostic variables associated with OS. In the validation cohort, the area under the ROC curve (AUC) for the nomogram model at 1, 3, and 5 years was 0.745, 0.771, and 0.748, respectively, while the AUC for the RSF model was 0.764, 0.792, and 0.761 at the same time points. ROC curve analysis indicated that both models demonstrated good accuracy and discrimination in predicting OS. Calibration curve analysis showed a strong consistency between the predicted and actual OS for both models. Both models effectively stratified the patients into poor and favorable prognosis groups, with the OS of patients in the poor prognosis group being significantly shorter than that of the favorable prognosis group (P<0.000 1). Decision curve analysis revealed that the net benefit of the RSF model was superior to that of the nomogram model. Compared to the nomogram model, the NRI for the RSF model was 0.184 (95%CI: 0.098~0.267, P<0.01), and the IDI was 0.300 (95%CI: 0.241~0.359, P<0.01). Overall, the RSF model demonstrated superior predictive capability than the nomogram model. Conclusion‍ ‍Ann Arbor stage, age, radiotherapy, combined treatment, and type of disease are prognostic factors affecting the prognosis of NKTL patients. Our RSF model demonstrates strong predictive capability for the prognosis of NKTL patients and can effectively assess patient outcomes. https://aammt.tmmu.edu.cn/html/202410090.htmlnatural killer t-cell lymphomaseer databasenomogrammachine learningrandom survival forestsurvival prediction
spellingShingle HUANG Zhen
HUANG Zhen
WU Yazhou
Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
陆军军医大学学报
natural killer t-cell lymphoma
seer database
nomogram
machine learning
random survival forest
survival prediction
title Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
title_full Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
title_fullStr Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
title_full_unstemmed Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
title_short Construction and validation of a prognostic model for NK/T-cell lymphoma based on random survival forest algorithm
title_sort construction and validation of a prognostic model for nk t cell lymphoma based on random survival forest algorithm
topic natural killer t-cell lymphoma
seer database
nomogram
machine learning
random survival forest
survival prediction
url https://aammt.tmmu.edu.cn/html/202410090.html
work_keys_str_mv AT huangzhen constructionandvalidationofaprognosticmodelfornktcelllymphomabasedonrandomsurvivalforestalgorithm
AT huangzhen constructionandvalidationofaprognosticmodelfornktcelllymphomabasedonrandomsurvivalforestalgorithm
AT wuyazhou constructionandvalidationofaprognosticmodelfornktcelllymphomabasedonrandomsurvivalforestalgorithm