Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests
Current lifestyle recommendations for cancer survivors are the same as those for the general public to decrease their risk of cancer. However, it is unclear which lifestyle behaviors are most important for prognosis. We aimed to identify which lifestyle behaviors were most important regarding colore...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/10/2442 |
| _version_ | 1797533663943983104 |
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| author | Moniek van Zutphen Fränzel J. B. van Duijnhoven Evertine Wesselink Ruud W. M. Schrauwen Ewout A. Kouwenhoven Henk K. van Halteren Johannes H. W. de Wilt Renate M. Winkels Dieuwertje E. Kok Hendriek C. Boshuizen |
| author_facet | Moniek van Zutphen Fränzel J. B. van Duijnhoven Evertine Wesselink Ruud W. M. Schrauwen Ewout A. Kouwenhoven Henk K. van Halteren Johannes H. W. de Wilt Renate M. Winkels Dieuwertje E. Kok Hendriek C. Boshuizen |
| author_sort | Moniek van Zutphen |
| collection | DOAJ |
| description | Current lifestyle recommendations for cancer survivors are the same as those for the general public to decrease their risk of cancer. However, it is unclear which lifestyle behaviors are most important for prognosis. We aimed to identify which lifestyle behaviors were most important regarding colorectal cancer (CRC) recurrence and all-cause mortality with a data-driven method. The study consisted of 1180 newly diagnosed stage I–III CRC patients from a prospective cohort study. Lifestyle behaviors included in the current recommendations, as well as additional lifestyle behaviors related to diet, physical activity, adiposity, alcohol use, and smoking were assessed six months after diagnosis. These behaviors were simultaneously analyzed as potential predictors of recurrence or all-cause mortality with Random Survival Forests (RSFs). We observed 148 recurrences during 2.6-year median follow-up and 152 deaths during 4.8-year median follow-up. Higher intakes of sugary drinks were associated with increased recurrence risk. For all-cause mortality, fruit and vegetable, liquid fat and oil, and animal protein intake were identified as the most important lifestyle behaviors. These behaviors showed non-linear associations with all-cause mortality. Our exploratory RSF findings give new ideas on potential associations between certain lifestyle behaviors and CRC prognosis that still need to be confirmed in other cohorts of CRC survivors. |
| first_indexed | 2024-03-10T11:17:49Z |
| format | Article |
| id | doaj.art-236e34f079044faaa11f7f1e26f9aee8 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T11:17:49Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-236e34f079044faaa11f7f1e26f9aee82023-11-21T20:14:15ZengMDPI AGCancers2072-66942021-05-011310244210.3390/cancers13102442Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival ForestsMoniek van Zutphen0Fränzel J. B. van Duijnhoven1Evertine Wesselink2Ruud W. M. Schrauwen3Ewout A. Kouwenhoven4Henk K. van Halteren5Johannes H. W. de Wilt6Renate M. Winkels7Dieuwertje E. Kok8Hendriek C. Boshuizen9Division of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsDepartment of Gastroenterology and Hepatology, Bernhoven Hospital, 5406 PT Uden, The NetherlandsDepartment of Surgery, Ziekenhuis Groep Twente, 7600 SZ Almelo, The NetherlandsDepartment of Internal Medicine, Admiraal de Ruyter Ziekenhuis, 4462 RA Goes, The NetherlandsDepartment of Surgery, Radboud University Medical Centre, 6500 HB Nijmegen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The NetherlandsCurrent lifestyle recommendations for cancer survivors are the same as those for the general public to decrease their risk of cancer. However, it is unclear which lifestyle behaviors are most important for prognosis. We aimed to identify which lifestyle behaviors were most important regarding colorectal cancer (CRC) recurrence and all-cause mortality with a data-driven method. The study consisted of 1180 newly diagnosed stage I–III CRC patients from a prospective cohort study. Lifestyle behaviors included in the current recommendations, as well as additional lifestyle behaviors related to diet, physical activity, adiposity, alcohol use, and smoking were assessed six months after diagnosis. These behaviors were simultaneously analyzed as potential predictors of recurrence or all-cause mortality with Random Survival Forests (RSFs). We observed 148 recurrences during 2.6-year median follow-up and 152 deaths during 4.8-year median follow-up. Higher intakes of sugary drinks were associated with increased recurrence risk. For all-cause mortality, fruit and vegetable, liquid fat and oil, and animal protein intake were identified as the most important lifestyle behaviors. These behaviors showed non-linear associations with all-cause mortality. Our exploratory RSF findings give new ideas on potential associations between certain lifestyle behaviors and CRC prognosis that still need to be confirmed in other cohorts of CRC survivors.https://www.mdpi.com/2072-6694/13/10/2442colorectal cancersurvivalrecurrencelifestylerandom survival forests |
| spellingShingle | Moniek van Zutphen Fränzel J. B. van Duijnhoven Evertine Wesselink Ruud W. M. Schrauwen Ewout A. Kouwenhoven Henk K. van Halteren Johannes H. W. de Wilt Renate M. Winkels Dieuwertje E. Kok Hendriek C. Boshuizen Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests Cancers colorectal cancer survival recurrence lifestyle random survival forests |
| title | Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests |
| title_full | Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests |
| title_fullStr | Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests |
| title_full_unstemmed | Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests |
| title_short | Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests |
| title_sort | identification of lifestyle behaviors associated with recurrence and survival in colorectal cancer patients using random survival forests |
| topic | colorectal cancer survival recurrence lifestyle random survival forests |
| url | https://www.mdpi.com/2072-6694/13/10/2442 |
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