Evaluating the use of machine learning use in ovarian cancer: A systematic review.

e17570 Background: Ovarian cancer(OC) is the leading cause of death from gynecologic malignancy. Current challenges include lack of diagnostic tools, predictive biomarkers, and identifying appropriate surgical candidates. Machine learning(ML) is an emerging field that can make accurate projections by making inferences on data and may play a crucial role in OC.The objective of the current study was to review the literature on application of ML in OC and report the most commonly used algorithms and their performance in comparison to existing prediction tools and traditional regression models. Methods: This is a systematic review of published literature from January 1985 to March 2021 on the use of ML in OC. An extensive search of electronic library databases was conducted. Four independent reviewers screened the articles initially by title then full text. Quality was assessed using the MINORS criteria. P-values were generated using the Pearson’s Chi-squared(x 2 ) test to compare performance of ML models with traditional statistics. No p-values were reported if only one study was available. Results: Among 4,295 articles screened, 88 studies on ML in OC were included. The mean age of OC patients was 54.7 years(11-90) and the most common stages at diagnosis were:Stage III (39.9%) and IV (34%). Applications of ML were in clinical datasets(33%, n = 29), preoperative diagnostics(30.7%, n = 27), serum biomarkers (21.6%, n = 19), genomics (12.5%, n = 11), and prediction of cytoreductive outcomes (2.3%, n = 2). The most commonly applied algorithms were Support Vector Machine [SVM](28%, n = 33)and Neural Networks[NN] (25.28%). Over the past decades, the number of publications on ML in OC increased three-fold from 20(1994-2010) to 67 (2011–2021). Only 9 (10%) studies compared ML techniques with existing prediction tools, or traditional regression models. Among 29 clinical dataset studies, 4 compared ML with traditional logistic regression(LR). Two studies reported better performance with ML compared to LR but not significant(accuracy: 0.88 vs 0.84, p = 0.15), one study performed comparably(accuracy: 0.1 vs 0.1) while one study performed worse(accuracy: 0.1 vs 0.97). Only one preoperative diagnostic study compared ML techniques with LR. SVM classifiers outperformed LR in classifying ovarian masses as benign or malignant(sensitivity: 0.88 vs. 0.70). One serum biomarker study compared LR with ML algorithms; LR performed better using two biomarkers for predicting OC(accuracy: 0.97 vs. 0.94). Among five studies reporting overall survival outcomes, only one study compared survival ML techniques using NN with LR and showed that NN classifiers outperformed LR in predicting overall survival(AUC: 0.72 vs. 0.62). Conclusions: This is the first systematic review exploring the literature on ML algorithms in OC. Most ML models outperformed traditional models. However, larger datasets would be required to validate findings.

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