Abstract
OBJECTIVE: The Eastern Cooperative Oncology Group performance status (ECOG PS) is a widely recognized measure used to assess the functional abilities of cancer patients and predict their prognosis. It plays a crucial role in guiding treatment decisions made by physicians. This study aimed to build a stacking ensemble-based prognosis predictor model for predicting the ECOG PS of a liver cancer patient undergoing treatment. METHODS: We used Light Gradient Boosting Machine (LightGBM) as the meta-model, and five base models, including Random Forest (RF), Extra Trees (ET), AdaBoost (Ada), Gradient Boosting Machine (GBM), and Extreme Gradient Boosting (XGBoost). After preprocessing the data and applying feature selection method, the stacking ensemble model was trained using 1622 liver cancer patients' data and 46 variables. We also integrated the stacking ensemble model with a LIME-based explainable model to obtain model prediction explainability. RESULTS: According to the research, the best combination of the stacking ensemble model is ET + XGBoost + RF + GBM + Ada + LightGBM and achieved a ROC AUC of 0.9826 on the training set and 0.9675 on the test set. CONCLUSIONS: This explainable stacking ensemble model can become a helpful tool for objectively predicting ECOG PS in liver cancer patients and aiding healthcare practitioners to adapt their treatment approach more effectively.