RT Journal Article
T1 Combining statistical techniques to predict postsurgical risk of 1-year mortality for patients with colon cancer.
A1 Arostegui, Inmaculada
A1 Gonzalez, Nerea
A1 Fernández-de-Larrea, Nerea
A1 Lázaro-Aramburu, Santiago
A1 Baré, Marisa
A1 Redondo, Maximino
A1 Sarasqueta, Cristina
A1 Garcia-Gutierrez, Susana
A1 Quintana, José M
A1 REDISSEC CARESS-CCR Group, 
K1 1-year-mortality
K1 clinical prediction rules
K1 colonic neoplasms
K1 colorectal surgery
K1 prediction model
K1 tree-based methods
AB Colorectal cancer is one of the most frequently diagnosed malignancies and a common cause of cancer-related mortality. The aim of this study was to develop and validate a clinical predictive model for 1-year mortality among patients with colon cancer who survive for at least 30 days after surgery. Patients diagnosed with colon cancer who had surgery for the first time and who survived 30 days after the surgery were selected prospectively. The outcome was mortality within 1 year. Random forest, genetic algorithms and classification and regression trees were combined in order to identify the variables and partition points that optimally classify patients by risk of mortality. The resulting decision tree was categorized into four risk categories. Split-sample and bootstrap validation were performed. ClinicalTrials.gov Identifier: NCT02488161. A total of 1945 patients were enrolled in the study. The variables identified as the main predictors of 1-year mortality were presence of residual tumor, American Society of Anesthesiologists Physical Status Classification System risk score, pathologic tumor staging, Charlson Comorbidity Index, intraoperative complications, adjuvant chemotherapy and recurrence of tumor. The model was internally validated; area under the receiver operating characteristic curve (AUC) was 0.896 in the derivation sample and 0.835 in the validation sample. Risk categorization leads to AUC values of 0.875 and 0.832 in the derivation and validation samples, respectively. Optimal cut-off point of estimated risk had a sensitivity of 0.889 and a specificity of 0.758. The decision tree was a simple, interpretable, valid and accurate prediction rule of 1-year mortality among colon cancer patients who survived for at least 30 days after surgery.
SN 1179-1349
YR 2018
FD 2018-03-06
LK https://hdl.handle.net/10668/26769
UL https://hdl.handle.net/10668/26769
LA en
DS RISalud
RD Apr 10, 2025