Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Canter, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
J Gastrointest Cancer. 2022 Mar;53(1):64-71. doi: 10.1007/s12029-020-00544-3. Epub 2020 Nov 10.
Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to develop and validate a random survival forest (RSF) to identify important risk factors on mortality in colorectal patients based on their demographic and clinical-related variables.
In this retrospective cohort study, the information of 317 patients with colorectal cancer who were referred to Imam Khomeini Clinic of Hamadan during the years of 2002 to 2017 were examined. Patient survival was calculated from the time of diagnosis to death. In the present study, the RSF model was used to identify factors affecting patient survival. Also, the results of the RSF model were compared with the Cox model. The data were analyzed using R software (version 3.6.1) and survival packages.
One-, 2-, 3-, 4-, 5-, and 10-year survival rates of included patients were 81.4%, 63%, 57%, 52%, 45%, and 34%, respectively, and the median survival was obtained to be 53 months. The number of 150 patients was died at this time period. The four most important predictors of survival included metastasis to other organs, WBC count, disease stage, and number of lymphomas involved. RSF method predicted survival better than the conventional Cox proportional hazard model.
We found that metastasis to other organs, WBC count, disease stage, and number of lymphomas involved were the most four most important predictors of low survival for colorectal cancer patients.
结直肠癌是最常见的癌症之一，也是伊朗癌症死亡的主要原因。本研究旨在开发和验证随机生存森林（RSF），以根据患者的人口统计学和临床相关变量确定结直肠患者死亡的重要危险因素。
在这项回顾性队列研究中，检查了 2002 年至 2017 年期间前往哈马丹伊玛目霍梅尼诊所的 317 名结直肠癌患者的信息。患者的生存时间从诊断到死亡计算。在本研究中，使用 RSF 模型来确定影响患者生存的因素。此外，还将 RSF 模型的结果与 Cox 模型进行了比较。数据使用 R 软件（版本 3.6.1）和生存包进行分析。
纳入患者的 1 年、2 年、3 年、4 年、5 年和 10 年生存率分别为 81.4%、63%、57%、52%、45%和 34%，中位生存时间为 53 个月。在此期间，有 150 名患者死亡。生存的四个最重要预测因素包括转移到其他器官、白细胞计数、疾病分期和受累的淋巴瘤数量。RSF 方法预测生存率优于传统的 Cox 比例风险模型。
我们发现转移到其他器官、白细胞计数、疾病分期和受累的淋巴瘤数量是结直肠癌患者低生存率的四个最重要预测因素。
