Factors affecting the survival of patients with colorectal cancer using random survival forest
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ORIGINAL RESEARCH
Factors affecting the survival of patients with colorectal cancer using random survival forest Ghodratollah Roshanaei 1
&
Malihe Safari 1 & Javad Faradmal 1 & Mohammad Abbasi 2 & Salman Khazaei 3
Accepted: 28 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose 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. Methods 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. Results 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. Conclusion 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. Keywords Colorectal cancer . Survival . Death . Hazard . Random survival forest
Introduction * Salman Khazaei [email protected] Ghodratollah Roshanaei [email protected] Malihe Safari [email protected] Javad Faradmal [email protected] Mohammad Abbasi [email protected] 1
Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Canter, Hamadan University of Medical Sciences, Hamadan, Iran
2
Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3
Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
Colorectal cancer is the third deadliest cancer in the world. This cancer affects approximately one million people annually, and half of them will die from the cancer [1]. This cancer is one of the leading causes of cancer death in different parts of the world with different intensities [2, 3]. Colorectal cancer incidence has been steadily rising worldwide, especially in developing countries that their lifestyle is changing to western way of life [4]. According to the Ministry of Health report, the incidence of this kind of cancer in Iran is lower than western countries, and i
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