Endometrial Cancer Individualized Scoring System (ECISS): A machine learning‐based prediction model of endometrial cancer prognosis

Abstract Objective To establish a prognostic model for endometrial cancer (EC) that individualizes a risk and management plan per patient and disease characteristics. Methods A multicenter retrospective study conducted in nine European gynecologic cancer centers. Women with confirmed EC between January 2008 to December 2015 were included. Demographics, disease characteristics, management, and follow‐up information were collected. Cancer‐specific survival (CSS) and disease‐free survival (DFS) at 3 and 5 years comprise the primary outcomes of the study. Machine learning algorithms were applied to patient and disease characteristics. Model I: pretreatment model. Calculated probability was added to management variables (model II: treatment model), and the second calculated probability was added to perioperative and postoperative variables (model III). Results Of 1150 women, 1144 were eligible for 3‐year survival analysis and 860 for 5‐year survival analysis. Model I, II, and III accuracies of prediction of 5‐year CSS were 84.88%/85.47% (in train and test sets), 85.47%/84.88%, and 87.35%/86.05%, respectively. Model I predicted 3‐year CSS at an accuracy of 91.34%/87.02%. Accuracies of models I, II, and III in predicting 5‐year DFS were 74.63%/76.72%, 77.03%/76.72%, and 80.61%/77.78%, respectively. Conclusion The Endometrial Cancer Individualized Scoring System (ECISS) is a novel machine learning tool assessing patient‐specific survival probability with high accuracy.