美国高发病率IV期癌症患者免疫治疗（IO）使用和生存趋势

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-01-13 DOI:10.1002/jso.28084

Samantha C Warwar, Lauren M Janczewski, Gladys M Rodriguez, Jeffrey D Wayne, David J Bentrem

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引用次数: 0

摘要

背景和目的：IO已经改变了癌症的管理，但其在晚期癌症患者中的应用因肿瘤类型而异。随着越来越多的IV期患者接受手术，了解这些具有挑战性的患者的部位特异性结果至关重要。我们旨在评估美国高发病率癌症的IV期癌症患者的IO使用和生存趋势。方法：从国家癌症数据库（2004-2020）中确定诊断为IV期前列腺癌、乳腺癌、黑色素瘤、结直肠癌、肾癌、膀胱癌、肺癌或胰腺癌的患者。Cochrane-Armitage检验和Kaplan-Meier方法评估了2004-2010年、2011-2015年和2016-2020年三个时期的IO和总生存率。结果：1 425 731例IV期癌症患者中，肺癌（50.0%）、胰腺癌（12.5%）和乳腺癌（9.3%）发生率最高，黑色素瘤发生率最低（2.2%）。从第1期到第3期，IO的使用从1.0%增加到24.6%，特别是黑色素瘤（9.5%到58.5%）。结论：IO的使用是肿瘤部位特异性的，与IV期癌症生存率的提高有关，不同类型的成功率不同。收款人的差异突出了确保公平收养的持续挑战。

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Trends in Immunotherapy (IO) Use and Survival Among Patients With High-Incidence Stage IV Cancers Across the United States.

Background and objectives: IO has transformed cancer management, but its adoption in advanced cancer patients varies by tumor type. With more Stage IV patients undergoing surgery, understanding site-specific outcomes in these challenging patients is essential. We aimed to evaluate IO use and survival trends for Stage IV cancer patients across high-incidence cancers in the US.

Methods: Patients diagnosed with Stage IV prostate, breast, melanoma, colorectal, renal, bladder, lung, or pancreas cancer were identified from the National Cancer Database (2004-2020). Cochrane-Armitage test and Kaplan-Meier methods assessed IO and overall survival across three periods: 2004-2010, 2011-2015, and 2016-2020.

Results: Among 1 425 731 Stage IV cancer patients, most had lung (50.0%), pancreas (12.5%), and breast cancer (9.3%), while the least had melanoma (2.2%). From periods 1 to 3, IO use increased from 1.0% to 24.6%, notably in melanoma (9.5% to 58.5%, p < 0.001). Melanoma exhibited the greatest survival gains (median survival: 7.1 to 14.9 months). Absolute increases in 3-year overall survival rates ranged from 3.4% in pancreas (1.7% to 5.1%) to 21.4% in melanoma (15.7% to 37.1%).

Conclusions: Utilization of IO is tumor-site specific and associated with improved survival rates for Stage IV cancer, with varied success across types. Variations in receipt highlight ongoing challenges to ensure equitable adoption.

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.