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Prognostic CART Analysis of Hess et al Starting with Lymph Node 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 lymph node metastases are present. The authors are from the University of Texas M.D. Anderson Cancer Center.


 

Parameters:

(1) lymph node

(2) histologic type

(3) number of sites involved

(4) liver metastases

(5) bone metastases

(6) adrenal gland metastases

(7) age of the patient in years

Node

Histo

Sites

Liver

Bone

Adrenal

Age

Group

pos

S, C, N

<= 2

 

 

 

 

E

pos

A

<= 2

 

 

 

 

C

pos

 

> 2

 

 

pos

 

C

pos

 

> 2

 

 

neg

 

A

neg

N

 

 

 

 

 

D

neg

S, C, A

 

neg

neg

 

 

C

neg

S, C, A

 

neg

pos

 

 

B

neg

S, C, A

 

pos

 

 

<= 61

B

neg

S, C, A

 

pos

 

 

> 61

A

 

where:

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

 

The CART analysis identified 9 groups, but I combined some of these to simplify the presentation.

 

Group

Median Survival

A

5 months

B

8 months

C

12 - 13 months

D

24 months

E

45 months

 


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