Use machine learning to predict bone metastasis of esophageal cancer: A population-based study.

Objective: The objective of this study is to develop a machine learning (ML)-based predictive model for bone metastasis (BM) in esophageal cancer (EC) patients. Methods: This study utilized data from the Surveillance, Epidemiology, and End Results database spanning 2010 to 2020 to analyze EC patients. A total of 21,032 confirmed cases of EC were included in the study. Through univariate and multivariate logistic regression (LR) analysis, 10 indicators associated with the risk of BM were identified. These factors were incorporated into seven different ML classifiers to establish predictive models. The performance of these models was assessed and compared using various metrics including the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, F-score, precision, and decision curve analysis. Results: Factors such as age, gender, histological type, T stage, N stage, surgical intervention, chemotherapy, and the presence of brain, lung, and liver metastases were identified as independent risk factors for BM in EC patients. Among the seven models developed, the ML model based on LR algorithm demonstrated excellent performance in the internal validation set. The AUC, accuracy, sensitivity, and specificity of this model were 0.831, 0.721, 0.787, and 0.717, respectively. Conclusion: We have successfully developed an online calculator utilizing a LR model to assist clinicians in accurately assessing the risk of BM in patients with EC. This tool demonstrates high accuracy and specificity, thereby enhancing the development of personalized treatment plans.