AUTHOR=Yuqin Li , Hongyan Li , Hongyuan Li , Tingting Li , Kun He , Jie Fang , Yunhui Han 

TITLE=Lymph node metastasis in patients with hepatocellular carcinoma using machine learning: a population-based study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1601985

DOI=10.3389/fonc.2025.1601985

ISSN=2234-943X

ABSTRACT=AimThis study aims to develo\p a population-adapted machine learning-based prediction model for hepatocellular carcinoma (HCC) lymph node metastasis (LNM) to identify high-risk patients requiring intensive surveillance.MethodsData from 23511 HCC patients in the SEER database and 57 patients from our hospital were analyzed. Seven LNM risk indicators were selected. Four machine learning algorithms—decision tree (DT), logistic Regression (LR), multilayer perceptron (MLP), and extreme gradient boosting (XGBoost)—were employed to construct prediction models. Model performance was evaluated using area under the curve, accuracy, sensitivity, and specificity.ResultsAmong 23511 SEER patients, 1679 (7.14%) exhibited LNM. Race, Sequence number, Tumor size, T stage and AFP were identified as independent predictors of LNM. The LR model achieved optimal performance (area under the curve: 0.751; accuracy: 0.707; sensitivity: 0.711; specificity: 0.661). External validation with 57 patients from our hospital confirmed robust generalizability (area under the curve: 0.73; accuracy: 0.737; sensitivity: 0.829; specificity: 0.5), outperforming other models.ConclusionsThe LR-based model demonstrates superior predictive capability for LNM in HCC, offering clinicians a valuable tool to guide personalized therapeutic strategies.