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Prognostic CART Analysis of Hess et al Starting with Liver Status for a Patient with a Metastatic Carcinoma from an Unknown Primary

Description

Hess et al used classification and regression tree (CART) analysis to evaluate prognosis for a patient with a metastatic carcinoma from an unknown primary site. One analysis starts from the whether or not metastases to the liver are present. The authors are from the University of Texas M.D. Anderson Cancer Center.


 

Parameters:

(1) liver

(2) bone metastases

(3) adrenal gland metastases

(4) lymph node metastases

(5) pleural metastases

(6) number of sites involved

(7) histologic type

(8) age of the patient in years

 

Liver

Bone

Adren

Nodal

Pleura

Sites

Histo

Age

Group

neg

neg

pos

 

 

 

 

 

A

neg

neg

neg

 

neg

<= 2

C, N, S

 

E

neg

neg

neg

 

neg

<= 2

A

 

C

neg

neg

neg

 

neg

> 2

 

 

C

neg

neg

neg

 

pos

 

 

 

B

neg

pos

 

pos

 

 

 

 

C

neg

pos

 

neg

 

 

 

 

B

pos

 

 

 

 

 

N

 

D

pos

 

 

 

 

 

C, S, A

<=61.5

B

pos

 

 

 

 

 

C, S. A

> 61.5

A

 

where:

• Histologic types: S = squamous; A = adenocarcinoma; N = neuroendocrine; C = carcinoma NOS

 

The CART analysis identified 10 groups, but I combined some of these to simplify the presentation.

 

Group

Median Survival

A

5 months

B

8 - 9 months

C

12 - 15 months

D

24 months

E

40 months

 


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