Collaborative machine learning-guided overall survival prediction of oral squamous cell carcinoma.

Background: There is a lack of prognosticators of overall survival (OS) for Oral Squamous Cell Carcinoma (OSCC).

Objectives: We examined collaborative machine learning (cML) in estimating the OS of OSCC patients. The prognostic significance of the clinicopathological parameters was examined.

Methodology: Altogether, 9439 OSCC patients were extracted from the Surveillance, Epidemiology, and End Results database (US). Five ML models - voting ensemble, stacked ensemble, extreme gradient boosting, light boosting, and logistic regression were used to predict OS. Three of these ML algorithms were combined to form a cluster of cML models. The performance of the cML was compared with the best performing individual ML algorithm following model training.

Results: The performance accuracy of the voting ensemble, stacked ensemble, extreme gradient boosting, light boosting, and logistic regression models was 70.2%, 69.9%, 69.1%, 69.4%, and 69.5% respectively, following model training. When the voting ensemble model was compared with cML using temporal validation, the cML showed a comparable performance accuracy. The most significant prognostic factors were age of the patient at diagnosis, T stage, tumor grade, marital status, gender, primary site, surgery, N stage, radiotherapy, ethnicity, chemotherapy, and M stage.

Conclusions: cML appears to give reliability to the final prediction and thereby may mark a paradigm shift from model individualism to a more cooperative paradigm. This approach may aid in determining an enhanced individualized treatment for OSCC patients.