Risk groups defined by Recursive Partitioning Analysis of patients with colorectal adenocarcinoma treated with colorectal resection.
BACKGROUND
To define different prognostic groups of surgical colorectal adenocarcinoma patients derived from recursive partitioning analysis (RPA).


METHODS
Ten thousand four hundred ninety four patients with colorectal adenocarcinoma underwent colorectal resection from Taiwan Cancer Database during 2003 to 2005 were included in this study. Exclusion criteria included those patients with stage IV disease or without number information of lymph nodes. For the definition of risk groups, the method of classification and regression tree was performed. Main primary outcome was 5-year cancer-specific survival.


RESULTS
We identified six prognostic factors for cancer-specific survival, resulting in seven terminal nodes. Four risk groups were defined as following: Group 1 (mild risk, 1,698 patients), Group 2 (moderate risk, 3,129 patients), Group 3 (high risk, 4,605 patients) and Group 4 (very high risk, 1,062 patients). The 5-year cancer-specific survival for Group 1, 2, 3, and 4 was 86.6%, 62.7%, 55.9%, and 36.6%, respectively (p < 0.001). Hazard ratio of death was 2.13, 5.52 and 10.56 (95% confidence interval 1.74-2.60, 4.58-6.66 and 8.66-12.9, respectively) times for Group 2, 3, and 4 as compared to Group 1. The predictive capability of these grouping was also similar in terms of overall and progression-free survival.


CONCLUSIONS
The use of RPA offered an alternative grouping method that could predict the survival of patients who underwent surgery for colorectal adenocarcinoma.
Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
Yun-Jau
YJ
Chang
Li-Ju
LJ
Chen
Yao-Jen
YJ
Chang
Kuo-Piao
KP
Chung
Mei-Shu
MS
Lai
D000230:Adenocarcinoma / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery*; D015897:Comorbidity; D003663:Decision Trees; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome