Gabriel De La Cruz Ku, Jiddu Antonio Guart, Jessica J Farzan, Anshumi Desai, Camila Franco, Jessica Mroueh, Vanessa Mroueh, Gonzalo Ziegler-Rodriguez
{"title":"拉丁裔中低收入国家III期黑色素瘤的真实世界数据：预后因素和结果。","authors":"Gabriel De La Cruz Ku, Jiddu Antonio Guart, Jessica J Farzan, Anshumi Desai, Camila Franco, Jessica Mroueh, Vanessa Mroueh, Gonzalo Ziegler-Rodriguez","doi":"10.1002/jso.28047","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Malignant melanoma is a heterogeneous disease, with varying outcomes depending on the patient's race and ethnicity. Advanced stages can be tackled by novel targeted therapies and immunotherapy. We aimed to investigate the real-world data in Latino-Hispanic patients diagnosed with Stage III melanoma residing in Peru, a region marked by limited resources and healthcare infrastructure.</p><p><strong>Methods: </strong>Patients diagnosed with Stage III melanoma at the Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru were included from the years 2010 to 2020. Cox regression analysis was used to assess prognostic factors.</p><p><strong>Results: </strong>Four hundred twelve patients were included, the median age of diagnosis was 63 years, with a male predominance (55.6%). Most of the patients presented with a lesion in the lower extremities (77.4%), acral lentiginous melanoma (35.4%), and ulcerated tumors (72.3%). 64.1% were diagnosed with Stage IIIC, and 27.2% received interferon-alpha therapy. With a median follow-up of 36 months, the relapse-free survival and overall survival rates were 26% and 78% at 3 years follow-up, respectively. Prognostic factors of event-free survival (EFS) were greater age (HR = 1.015, 95% CI: 1.005-1.025), ulcerated lesions (HR = 1.855, 95% CI: 1.221-2.820), N category, and the administration of interferon therapy (HR = 0.680, 95% CI: 0.488-0.947). While worse overall survival (OS) was associated with greater ages (HR = 1.032, 95% CI: 1.011-1.053) and the presence of ulceration (HR = 2.992, 95% CI:1.142-7.835).</p><p><strong>Conclusion: </strong>Stage III melanoma in the Hispanic-Latino population from Peru has worse survival rates than other races and populations despite similar prognostic factors of worse EFS and OS. In resource-limited settings, reducing barriers to receiving healthcare and broadening access to contemporary immunotherapy and targeted therapy are crucial measures to improve outcomes in patients with advanced melanoma.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Real World Data in Stage III Melanoma in Latino Low Middle Income Country: Prognostic Factors and Outcomes.\",\"authors\":\"Gabriel De La Cruz Ku, Jiddu Antonio Guart, Jessica J Farzan, Anshumi Desai, Camila Franco, Jessica Mroueh, Vanessa Mroueh, Gonzalo Ziegler-Rodriguez\",\"doi\":\"10.1002/jso.28047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Malignant melanoma is a heterogeneous disease, with varying outcomes depending on the patient's race and ethnicity. Advanced stages can be tackled by novel targeted therapies and immunotherapy. We aimed to investigate the real-world data in Latino-Hispanic patients diagnosed with Stage III melanoma residing in Peru, a region marked by limited resources and healthcare infrastructure.</p><p><strong>Methods: </strong>Patients diagnosed with Stage III melanoma at the Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru were included from the years 2010 to 2020. Cox regression analysis was used to assess prognostic factors.</p><p><strong>Results: </strong>Four hundred twelve patients were included, the median age of diagnosis was 63 years, with a male predominance (55.6%). Most of the patients presented with a lesion in the lower extremities (77.4%), acral lentiginous melanoma (35.4%), and ulcerated tumors (72.3%). 64.1% were diagnosed with Stage IIIC, and 27.2% received interferon-alpha therapy. With a median follow-up of 36 months, the relapse-free survival and overall survival rates were 26% and 78% at 3 years follow-up, respectively. Prognostic factors of event-free survival (EFS) were greater age (HR = 1.015, 95% CI: 1.005-1.025), ulcerated lesions (HR = 1.855, 95% CI: 1.221-2.820), N category, and the administration of interferon therapy (HR = 0.680, 95% CI: 0.488-0.947). While worse overall survival (OS) was associated with greater ages (HR = 1.032, 95% CI: 1.011-1.053) and the presence of ulceration (HR = 2.992, 95% CI:1.142-7.835).</p><p><strong>Conclusion: </strong>Stage III melanoma in the Hispanic-Latino population from Peru has worse survival rates than other races and populations despite similar prognostic factors of worse EFS and OS. In resource-limited settings, reducing barriers to receiving healthcare and broadening access to contemporary immunotherapy and targeted therapy are crucial measures to improve outcomes in patients with advanced melanoma.</p>\",\"PeriodicalId\":17111,\"journal\":{\"name\":\"Journal of Surgical Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-12-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jso.28047\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.28047","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Real World Data in Stage III Melanoma in Latino Low Middle Income Country: Prognostic Factors and Outcomes.
Introduction: Malignant melanoma is a heterogeneous disease, with varying outcomes depending on the patient's race and ethnicity. Advanced stages can be tackled by novel targeted therapies and immunotherapy. We aimed to investigate the real-world data in Latino-Hispanic patients diagnosed with Stage III melanoma residing in Peru, a region marked by limited resources and healthcare infrastructure.
Methods: Patients diagnosed with Stage III melanoma at the Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru were included from the years 2010 to 2020. Cox regression analysis was used to assess prognostic factors.
Results: Four hundred twelve patients were included, the median age of diagnosis was 63 years, with a male predominance (55.6%). Most of the patients presented with a lesion in the lower extremities (77.4%), acral lentiginous melanoma (35.4%), and ulcerated tumors (72.3%). 64.1% were diagnosed with Stage IIIC, and 27.2% received interferon-alpha therapy. With a median follow-up of 36 months, the relapse-free survival and overall survival rates were 26% and 78% at 3 years follow-up, respectively. Prognostic factors of event-free survival (EFS) were greater age (HR = 1.015, 95% CI: 1.005-1.025), ulcerated lesions (HR = 1.855, 95% CI: 1.221-2.820), N category, and the administration of interferon therapy (HR = 0.680, 95% CI: 0.488-0.947). While worse overall survival (OS) was associated with greater ages (HR = 1.032, 95% CI: 1.011-1.053) and the presence of ulceration (HR = 2.992, 95% CI:1.142-7.835).
Conclusion: Stage III melanoma in the Hispanic-Latino population from Peru has worse survival rates than other races and populations despite similar prognostic factors of worse EFS and OS. In resource-limited settings, reducing barriers to receiving healthcare and broadening access to contemporary immunotherapy and targeted therapy are crucial measures to improve outcomes in patients with advanced melanoma.
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.
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