贝叶斯伽玛-功率-混合活性回归模型:预测前列腺癌再生前列腺切除术

A Bayesian Gamma-power-mixture survival regression model: predicting the recurrence of prostate cancer post-prostatectomy

In a dataset of 423 patients who had had radical prostatectomy for localised prostate cancer we estimated the apparent Shannon information (ASI) about time to biochemical recurrence in various subsets of the available pre-op variables using a Bayesian Gamma-power-mixture survival regression model. In all the subsets examined the ASI was positive with posterior probability greater than 0.975 . Using only age and results of pre-operative blood tests (PSA and biomarkers) we achieved 0.232 (0.180 to 0.290) nats ASI (0.335 (0.260 to 0.419) bits) (posterior mean and equitailed 95% posterior confidence intervals). This is more than double the mean posterior ASI previously achieved on the same dataset by a subset of the current authors using a log-skew-Student-mixture model, and is greater than that previous value with posterior probability greater than 0.99 . Additionally using pre- or post-operative Gleason grades, operative findings, clinical stage, and presence or absence of extraprostatic extension or seminal vesicle invasion did not increase the ASI extracted. However removing the blood-based biomarkers and replacing them with either pre-operative Gleason grades or findings available from MRI scanning greatly reduced the available ASI to respectively 0.077 (0.038 to 0.120) and 0.088 (0.045 to 0.132) nats (both less than the values using blood-based biomarkers with posterior probability greater than 0.995). A greedy approach to selection of the best biomarkers gave TGFbeta1, VCAM1, IL6sR, and uPA in descending order of importance from those examined.