Abstract
The prediction of tumor in the TNM staging (tumor, node, and metastasis) stage of colon cancer using the most influential histopathology parameters and to predict the five years disease-free survival (DFS) period using machine learning (ML) in clinical research have been studied here. From the colorectal cancer (CRC) registry of Chang Gung Memorial Hospital, Linkou, Taiwan, 4021 patients were selected for the analysis. Various ML algorithms were applied for the tumor stage prediction of the colon cancer by considering the Tumor Aggression Score (TAS) as a prognostic factor. Performances of different ML algorithms were evaluated using five-fold cross-validation, which is an effective way of the model validation. The accuracy achieved by the algorithms taking both cases of standard TNM staging and TNM staging with the Tumor Aggression Score was determined. It was observed that the Random Forest model achieved an F-measure of 0.89, when the Tumor Aggression Score was considered as an attribute along with the standard attributes normally used for the TNM stage prediction. We also found that the Random Forest algorithm outperformed all other algorithms, with an accuracy of approximately 84% and an area under the curve (AUC) of 0.82 ± 0.10 for predicting the five years DFS.
Highlights
According to the World Cancer Research Fund, colorectal cancer is the third most common cancer worldwide, which has affected over 1.8 million new patients in 2018 [1]
We investigated the role of tumor-related histopathology parameters such as CirInvo, TumrDiff, Tumrlen, and Tumrwid for predicting the tumor stage of colon cancer and to find the relationship between the Tumor Aggression Score (TAS) and five years disease-free survival (DFS)
It is to be noted that parameters such as only tumor size, N stage, and metastasis are considered in the standard TNM staging method
Summary
According to the World Cancer Research Fund, colorectal cancer is the third most common cancer worldwide, which has affected over 1.8 million new patients in 2018 [1]. According to a report issued by the Health Promotion Administration, Taiwan, colorectal cancer topped at the list of most commonly occurring cancer in 2016 [2]. Based on the death rate, colorectal cancer is the second leading cause of death in the United States, where the number of deaths was 14.2 per 100,000 men and women per year based on 2012–2016 deaths statistics [3]. In Taiwan, colorectal cancer ranked as the third leading cause. There were 47,760 deaths due to cancer, which accounted for 27.7%. The crude death rate for CRC was 24.3 deaths per 100,000 populations, an increase of 0.1% compared to the previous year; the age-adjusted death rate was 14.6 deaths per
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