The National Cancer Data Base report on the utilization of an adjuvant immunotherapy in stage III melanoma in relation to age.

e19000 Background: The 5-year survival of Stage III melanoma ranges from 30-70%. High dose interferon alfa-2b (IFN) is an adjuvant immunotherapy approved in 1995 for stage III melanoma, however, its use has been limited by its significant toxicity and modest benefit. We hypothesized the utilization of adjuvant immunotherapy is less in older age group compared to younger patients. Methods: Using the National Cancer Data Base (NCDB) aggregate data, demographic, socioeconomic, insurance information, and treatment data were analyzed. Proportions were compared using Pearson Chi squared tests. Results: From 2000-2008, 27,365 cases of stage III melanoma were reported to NCDB. Most patients were male (63%) and Caucasian (94.2%). Twenty-nine percent were over the age of 70. Educational and socioeconomic factors across all age groups were not significantly different. The primary insurer for patients younger than 60 was a managed care plan (54.3%) as compared to Medicare with supplemental insurance for patients older than 60 (47.4%). In terms of systemic therapy, 23% received immunotherapy alone, 6% received chemotherapy alone, 2% received both, and 66% received no therapy. When compared to patients under age 39, older age groups were significantly less likely to receive adjuvant immunotherapy as shown in the table below. Conclusions: There is an inverse relationship between age and the use of adjuvant immunotherapy. Further study is planned to adjust for comorbidity, socioeconomic status using patient-level data. [Table: see text]

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Trends and variations in the use of adjuvant immunotherapy for stage III melanoma in the U.S. population.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9077 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 9077-9077 ◽

Cited By ~ 1

Author(s):

Teresa J. Nasabzadeh ◽

Huei-Ting Tsai ◽

Eshetu Tefera ◽

Suraj S. Venna ◽

Arnold L. Potosky ◽

...

Keyword(s):

Multiple Logistic Regression Analysis ◽

Geographic Region ◽

Stage Iii ◽

High Dose ◽

Limited Information ◽

Clinical Factors ◽

Adjuvant Immunotherapy ◽

Cancer Data ◽

Clinical Variables ◽

Stage Iii Melanoma

9077 Background: High dose Interferon alfa-2b (IFN), an adjuvant immunotherapy for patients (pts) with stage III melanoma, was the only approved treatment option in the US from 1995-2011. There is limited information on how high dose IFN has been disseminated to eligible pts in general clinical practice, and whether variations exist in its adoption according to non-clinical factors. Methods: We obtained data on 34,208 pts diagnosed between 1998-2010 with stage III melanoma from the National Cancer Data Base (NCDB). IFN treatment was abstracted as immunotherapy. We investigated the use of immunotherapy according to pt demographic, socioeconomic, and clinical variables. We conducted multiple logistic regression analysis to examine the effect of these variables on the receipt of immunotherapy. Results: 62% of pts in our study population were male, 88% were Caucasian and 31% were over age 65. Overall, 27% of the pts received immunotherapy. There was no significant trend in its adoption between year 1998 and 2010. After adjustment for clinical variables, age at diagnosis, facility type, and geographic region are predictors strongly associated with use of immunotherapy. Only 16% of pts aged 65-74 and 3% over 75 received immunotherapy compared to 42% of those ages less than 45 (adjusted ORs 0.44 [0.32-0.59], 0.05 [0.04-0.14), respectively). Also 24% of pts treated at a comprehensive community cancer program received immunotherapy compared to 30% of those treated at an academic/research program (OR, 0.71 [0.51-0.99]). The frequency of immunotherapy was 25% in the Atlantic region and 17% in the Western region compared to 33% in Northeast (ORs 0.42 [0.18-0.99], 0.31 [0.13-0.74], respectively). Median household income, insurance type and comorbidity were not associated with adoption of immunotherapy after adjustment for all other variables. Conclusions: Less than one-third of all eligible patients received adjuvant immunotherapy in US general practice over the past decade. There is significant variation in its adoption according to non-clinical factors. Further exploration of the reasons for these variations and whether they are linked to important patient outcomes is needed.

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The Influence of Postoperative Lymph Node Radiation Therapy on Overall Survival of Patients With Stage III Melanoma: A National Cancer Data Base Analysis

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.381 ◽

2016 ◽

Vol 96 (2) ◽

pp. S157-S158

Author(s):

H. Danish ◽

K. Patel ◽

J. Switchenko ◽

T.W. Gillespie ◽

J. Jhaveri ◽

...

Keyword(s):

Overall Survival ◽

Radiation Therapy ◽

Lymph Node ◽

Data Base ◽

National Cancer Data Base ◽

Stage Iii ◽

Cancer Data ◽

Base Analysis ◽

Stage Iii Melanoma

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Omitting Radiation From Adjuvant Management of Stage III Endometrial Cancer Is Associated With Reduced Survival: An Analysis From The National Cancer Data Base (NCDB)

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.1349 ◽

2016 ◽

Vol 96 (2) ◽

pp. E288

Author(s):

C.J. Wang ◽

A. Christie ◽

M.R. Folkert ◽

X.J. Xie ◽

K.V. Albuquerque

Keyword(s):

Endometrial Cancer ◽

Data Base ◽

National Cancer Data Base ◽

Stage Iii ◽

Cancer Data

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Disparities in the Age-Related Rates of Colorectal Cancer in the United States

The American Surgeon ◽

10.1177/000313481708300631 ◽

2017 ◽

Vol 83 (6) ◽

pp. 640-647 ◽

Cited By ~ 1

Author(s):

Emmanuel Gabriel ◽

Katherine Ostapoff ◽

Kristopher Attwood ◽

Eisar Al-Sukhni ◽

Patrick Boland ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Age Groups ◽

The United States ◽

National Cancer Data Base ◽

Stage Iii ◽

Cancer Data ◽

Age Related ◽

Rate Of Increase ◽

Hispanic Patients

The incidence of colorectal cancer (CRC) among Americans under the age of 50 years is increasing. The purpose of this study was to identify racial and socioeconomic disparities associated with this trend. The National Cancer Data Base was used to identify patients with CRC from 1998 to 2011. Patients were stratified by age (<50 versus >60 years), with ages 50 to 60 years omitted from the analysis to minimize overlapping trends between the two age groups. Relative frequencies (RFs) by year were plotted against demographic variables. Changes in RF over time and intervals from diagnosis to treatment (including surgery and chemotherapy) were compared. A total of 1,213,192 patients were studied; 885,510 patients with colon cancer and 327,682 with rectal or rectosigmoid cancer. Patients <50 years had higher RF for stage III/IV CRC compared with >60 years, with the highest rate of increase in stage III colon cancer (0.198% per year). Patients <50 years had higher RF for CRC if they were African-American or Hispanic. Hispanic patients <50 years had the highest rates of increase for both colon (RF = 0.300% per year) and rectal cancer (RF = 0.248% per year). Compared with race, other variables including education and income were not found to have as strong an association on age-related rates of CRC. No clinically significant differences were observed for time from diagnosis to treatment in either age group. Important racial disparities are associated with differences in age-related CRC rates, warranting further investigation to develop improved strategies for the earlier detection of CRC in these populations.

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