A Random Forest and SMOTE-Based Machine Learning Model for Predicting Recurrence in Papillary Thyroid Carcinoma

PTC (Papillary Thyroid Carcinoma) is one subtype of thyroid cancer occurred most frequently in thyroid cancer cases. Although the prognosis of this cancer is typically positive, its recurrence remains a key challenge requiring early detection. This study proposes machine learning models to predict PTC recurrence, explicitly addressing the inherent class imbalance in the recurrence data. This study implemented three supervised learning algorithms, namely Random Forest (RF), Extreme Gradient Boost (XGB), and Support Vector Machine (SVM) with the Synthetic Minority Oversampling Technique (SMOTE) to balance the dataset. SMOTE was chosen for its capacity to generate synthetic minority class samples while minimizing information loss, thus effectively addressing class imbalance and improving classification outcomes. Model performance was assessed using accuracy, precision, recall (sensitivity), and F1-score. Among all approaches tested, RF with SMOTE demonstrated superior performance, achieving 0.98 accuracy, perfect precision (1.0), high recall (sensitivity) (0.95), and a strong F1-score (0.97), outperforming previous methods including SMOTEENN-based approaches. The result of this study demonstrates SMOTE specifically outperforms SMOTEENN in this clinical context, likely due to better preservation of subtle prognostic indicators with minimal information loss. This improvement suggests SMOTE's effectiveness in preserving valuable decision boundary information while addressing class imbalance in PTC recurrence prediction. These findings establish RF with SMOTE as a robust and well-balanced approach for predicting PTC recurrence, contributing significantly to the development of more precise and responsive AI-driven decision support tools for thyroid cancer.