Eric J Kim, James Y Lee, Arjun Ganga, Andrew Barton, Viren Rana, Ermias Araia, William Adriance, Rachel Wang, Ponnandai Somasundar, Leo A Kim
{"title":"医疗补助状况对葡萄膜黑色素瘤5年生存率的分析:一项全国性分析。","authors":"Eric J Kim, James Y Lee, Arjun Ganga, Andrew Barton, Viren Rana, Ermias Araia, William Adriance, Rachel Wang, Ponnandai Somasundar, Leo A Kim","doi":"10.1080/09286586.2023.2280962","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The survival outcomes of patients with primary uveal melanomas based on Medicaid status have not been previously discussed in the literature.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results Medicaid database were utilized to identify patients with primary uveal melanomas diagnosed between 2006 and 2013. The Kaplan-Meier method was utilized to construct 5-year survival curves in adult, non-elderly patients. Log-rank testing was used to determine differences in survival rates, and multivariate Cox proportional hazards modeling was utilized to perform adjusted survival analysis.</p><p><strong>Results: </strong>A total of 1,765 patients were included (Medicaid: 81, non-Medicaid: 1684). A total of 1683 (95.4%) were White. The average age was 51.75 years (SD = 9.5 years). Medicaid patients were more likely to be unmarried, live in a high poverty neighborhood, and live in a rural area (all <i>p</i> < .001). We observed no significant difference in 5-year survival rates between those enrolled in Medicaid (86.6%, 95% CI: 79.1%1-94.7%) and those not enrolled in Medicaid (85.5, 95% CI: 83.8%-87.2%) (<i>p</i> = .80). After controlling for socioeconomic and clinical factors, Medicaid enrollment was not associated with an increased risk of mortality compared to non-Medicaid enrollment. Age (aHR: 1.04, 95% CI: 1.02-1.06, <i>p</i> < .001) and tumor size >10 mm (aHR: 3.04, 95% CI: 1.49-6.21, <i>p</i> = .002) were associated with an increased risk of mortality.</p><p><strong>Conclusion: </strong>Medicaid enrollment was not associated with worse cancer-specific 5-year survival. Further research needs to be elicited to better understand the role of Medicaid enrollment in patients with primary uveal melanoma.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"385-391"},"PeriodicalIF":1.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of Uveal Melanoma 5-Year Survival Rates by Medicaid Status: A Nationwide Analysis.\",\"authors\":\"Eric J Kim, James Y Lee, Arjun Ganga, Andrew Barton, Viren Rana, Ermias Araia, William Adriance, Rachel Wang, Ponnandai Somasundar, Leo A Kim\",\"doi\":\"10.1080/09286586.2023.2280962\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The survival outcomes of patients with primary uveal melanomas based on Medicaid status have not been previously discussed in the literature.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results Medicaid database were utilized to identify patients with primary uveal melanomas diagnosed between 2006 and 2013. The Kaplan-Meier method was utilized to construct 5-year survival curves in adult, non-elderly patients. Log-rank testing was used to determine differences in survival rates, and multivariate Cox proportional hazards modeling was utilized to perform adjusted survival analysis.</p><p><strong>Results: </strong>A total of 1,765 patients were included (Medicaid: 81, non-Medicaid: 1684). A total of 1683 (95.4%) were White. The average age was 51.75 years (SD = 9.5 years). Medicaid patients were more likely to be unmarried, live in a high poverty neighborhood, and live in a rural area (all <i>p</i> < .001). We observed no significant difference in 5-year survival rates between those enrolled in Medicaid (86.6%, 95% CI: 79.1%1-94.7%) and those not enrolled in Medicaid (85.5, 95% CI: 83.8%-87.2%) (<i>p</i> = .80). After controlling for socioeconomic and clinical factors, Medicaid enrollment was not associated with an increased risk of mortality compared to non-Medicaid enrollment. Age (aHR: 1.04, 95% CI: 1.02-1.06, <i>p</i> < .001) and tumor size >10 mm (aHR: 3.04, 95% CI: 1.49-6.21, <i>p</i> = .002) were associated with an increased risk of mortality.</p><p><strong>Conclusion: </strong>Medicaid enrollment was not associated with worse cancer-specific 5-year survival. Further research needs to be elicited to better understand the role of Medicaid enrollment in patients with primary uveal melanoma.</p>\",\"PeriodicalId\":19607,\"journal\":{\"name\":\"Ophthalmic epidemiology\",\"volume\":\" \",\"pages\":\"385-391\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmic epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/09286586.2023.2280962\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09286586.2023.2280962","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:基于医疗补助状态的原发性葡萄膜黑色素瘤患者的生存结局在以前的文献中没有讨论过。方法:利用医疗补助数据库的监测、流行病学和最终结果来识别2006年至2013年诊断的原发性葡萄膜黑色素瘤患者。采用Kaplan-Meier法构建成人非老年患者的5年生存曲线。采用Log-rank检验确定生存率差异,采用多变量Cox比例风险模型进行调整生存率分析。结果:共纳入1765例患者(医疗补助81例,非医疗补助1684例)。白鼠1683只(95.4%)。平均年龄51.75岁(SD = 9.5岁)。接受医疗补助的患者更有可能未婚、生活在高度贫困社区和生活在农村地区(所有p p = 0.80)。在控制了社会经济和临床因素后,与未参加医疗补助计划的人相比,参加医疗补助计划的人与死亡风险增加无关。年龄(aHR: 1.04, 95% CI: 1.02-1.06, p = 0.10 mm)与死亡风险增加相关。结论:加入医疗补助计划与较差的癌症特异性5年生存率无关。需要进行进一步的研究,以更好地了解医疗补助计划在原发性葡萄膜黑色素瘤患者中的作用。
Analysis of Uveal Melanoma 5-Year Survival Rates by Medicaid Status: A Nationwide Analysis.
Purpose: The survival outcomes of patients with primary uveal melanomas based on Medicaid status have not been previously discussed in the literature.
Methods: The Surveillance, Epidemiology, and End Results Medicaid database were utilized to identify patients with primary uveal melanomas diagnosed between 2006 and 2013. The Kaplan-Meier method was utilized to construct 5-year survival curves in adult, non-elderly patients. Log-rank testing was used to determine differences in survival rates, and multivariate Cox proportional hazards modeling was utilized to perform adjusted survival analysis.
Results: A total of 1,765 patients were included (Medicaid: 81, non-Medicaid: 1684). A total of 1683 (95.4%) were White. The average age was 51.75 years (SD = 9.5 years). Medicaid patients were more likely to be unmarried, live in a high poverty neighborhood, and live in a rural area (all p < .001). We observed no significant difference in 5-year survival rates between those enrolled in Medicaid (86.6%, 95% CI: 79.1%1-94.7%) and those not enrolled in Medicaid (85.5, 95% CI: 83.8%-87.2%) (p = .80). After controlling for socioeconomic and clinical factors, Medicaid enrollment was not associated with an increased risk of mortality compared to non-Medicaid enrollment. Age (aHR: 1.04, 95% CI: 1.02-1.06, p < .001) and tumor size >10 mm (aHR: 3.04, 95% CI: 1.49-6.21, p = .002) were associated with an increased risk of mortality.
Conclusion: Medicaid enrollment was not associated with worse cancer-specific 5-year survival. Further research needs to be elicited to better understand the role of Medicaid enrollment in patients with primary uveal melanoma.
期刊介绍:
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.