Purpose: To evaluate retrospectively the ability of an artificial neural ne
twork (ANN) to predict bladder cancer recurrence within 6 months of diagnos
is and stage progression in patients with Ta/T1 bladder cancer, and 12-mont
h cancer-specific survival in patients with T2-T4 bladder cancer.
Materials and Methods: Data were analyzed using a NeuralWorks Professional
II/Plus software package. The input neural data consisted of clinicopatholo
gical and molecular characteristics. Distinct patient groups were used for
the prediction of stage progression and tumor recurrence in Ta/T1 bladder c
ancers, and 12-month cancer-specific survival for patients with T2-T4 tumor
s. ANN predictions were compared with those of four consultant urologists.
Results: The accuracy of the neural network in predicting stage progression
and recurrence within 6 months for Ta/T1 tumors and 12-month cancer-specif
ic survival for T2-T4 cancers was 80%, 75% and 82% respectively; with corre
sponding figures for clinicians being 74%, 79% and 65%. On restricting the
validation subset to patients with T1G3 tumors in relation to stage progres
sion, the sensitivity of the ANN analysis increased to 100% with a specific
ity of 78% and an overall accuracy of 82%. The performance of the ANN in pr
edicting stage progression in T1G3 tumors was significantly higher than tha
t of clinicians (p = 0.25 for the ANN and p = 0.008 for clinicians, McNemar
test).
Conclusions: Data analysis using an ANN has been shown to be a useful adjun
ct in predicting outcomes in patients with bladder cancer and out-performs
clinicians' predictions of stage progression in the high risk group of pati
ents with T1G3 disease.