Impact of pretreatment serum creatinine on outcomes in pancreatic adenocarcinoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15749-e15749
Author(s):  
Taha Alrifai ◽  
Faisal Ali ◽  
Zimu Gong ◽  
Phyo Thazin Myint ◽  
Karan Nijhawan ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Pancreatic Adenocarcinoma ◽  
Cancer Cachexia ◽  
Statistical Significance ◽  
Surrogate Marker ◽  
Cost Effective ◽  
Prognostic Indicator ◽  
Kaplan Meier ◽  
The Impact ◽  
Pretreatment Serum

e15749 Background: Pancreatic Adenocarcinoma (PA) is an aggressive malignancy with an estimated 5-year survival of 8.5%. PA was responsible for 7.3% of all cancer deaths in 2018 in the US. We aimed to evaluate the impact of pretreatment serum creatinine (SCr) level on Overall Survival (OS) in patients with PA. Methods: A retrospective review of electronic health records of patients with PA seen at our institution between 01/2014 and 01/2018 was done. We collected patients’ SCr at the time of diagnosis, and excluded patients with a glomerular filtration rate (GFR) below 60 mL/min per 1.73 m2 or SCr > 1.3 mg/dL. Patients were dichotomized around a SCr of 0.5 mg/dL. Kaplan-Meier survival estimate was performed to evaluate statistical significance. Results: A total of 83 patients, including 37 females and 46 males, with a median age at diagnosis of 67 years, were included. SCr of < 0.5 mg/dL was associated with a lower median OS as compared to a SCr of ≥0.5 mg/dL, (253 days versus 364 days; P = 0.035). There were more female patients in the low SCr group (71% vs 39%, P = 0.027). Patients with SCr of < 0.5 mg/dL had a lower mean BMI compared to patients with a SCr of ≥0.5 mg/dL, however this was not statistically significant (BMI = 22.45 versus 25.72; P = 0.49). Conclusions: Low SCr is predictive of a lower median OS in patients with PA. SCr has been suggested as a surrogate marker for muscle mass, which is closely associated with the degree of cancer cachexia. Our finding emphasizes the need for future larger studies to evaluate the utility of SCr as a prognostic indicator, as well as a cost-effective surrogate for measuring cancer cachexia. [Table: see text]

Abstract 16084: Relationship Between Diastolic Interventricular Septal Flattening and Prognosis in Patients With Severe Tricuspid Regurgitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Omori Taku ◽  
Goki Uno ◽  
Shunsuke Shimada ◽  
Takahiro Shiota
Keyword(s):  
Tricuspid Regurgitation ◽  
Cardiac Death ◽  
Surrogate Marker ◽  
Clinical Information ◽  
Right Atrial ◽  
Cardiac Events ◽  
Severe Tricuspid Regurgitation ◽  
Kaplan Meier ◽  
Advanced Therapy ◽  
The Impact

Introduction: Diastolic interventricular septal flattening is one of the major findings in patients with severe tricuspid regurgitation (TR). However, the relationship between diastolic interventricular septal flattening and outcome in patients with severe TR is not fully understood. This study aimed to investigate the impact of diastolic interventricular septal flattening on cardiac events in patients with severe TR. Methods: We retrospectively reviewed patients who underwent 2 dimensional echocardiography and were diagnosed as severe TR in 2014. Eccentricity index in end-diastole (EI-ED) was measured as septal wall configuration (Figure). Cardiac events investigated as endpoints were cardiac death and heart failure (HF) admission. Results: 376 patients were diagnosed as severe TR. We excluded 15 patients on mechanical respiratory support during echocardiography and 20 with missing data of clinical information. Remaining 341 severe TR patients (75 ± 16 years, 191 (56%) female) were investigated in this study.232 (68%) patients showed abnormal EI-ED (defined as over 1.0). During a follow-up period (median, 183 days; range. 40 to 983 days), 119 (34%) patients experienced cardiac events (29 cardiac death and 90 HF admission). By the Cox proportional hazard model, the presence of abnormal EI-ED and right atrial pressure (RAP) elevation on echocardiography (defined as more than 8mmHg) were independent predictors for cardiac events with a hazard ratio of 2.71 (95% Confidential interval (CI), 1.25 to 5.86; p=0.011) and of 3.02 (95%CI, 1.08 to 8,47; p=0.036) respectively. The Kaplan-Meier curves showed that severe TR patients with abnormal EI-ED and RAP elevation were at higher risk for cardiac event (Figure). Conclusions: The presence of abnormal EI-ED is an important predictor for cardiac events in patients with severe TR. The presence of abnormal EI-ED and RAP elevation can be a potential surrogate marker of advanced therapy for severe TR.

scholarly journals The Survival of Cultural Firms: A Study of Multiple Accounting Parameters in Spain

2020 ◽  
Vol 12 (3) ◽  
pp. 1159
Author(s):  
Ma del Pilar Muñoz Dueñas ◽  
Antonio Vaamonde Liste ◽  
Maria do Rosário Cabrita
Keyword(s):  
Cultural Heritage ◽  
Cox Regression ◽  
Statistical Significance ◽  
Intangible Cultural Heritage ◽  
Cultural Industry ◽  
Key Factors ◽  
Factors Associated ◽  
Development Factor ◽  
Kaplan Meier ◽  
The Impact

Cultural firms are an important development factor in economic and social terms. Their objectives are often aimed at maintaining and disseminating the traditions and values of societies. The prosperity of these firms in a nation ensures that its tangible and intangible cultural heritage is made known to other nations and generations. Despite their importance, little is known about their survival and the factors associated with it. This paper analyses data from 6951 Spanish firms, of which 2105 are cultural firms. We have studied the survival of non-cultural firms in comparison with cultural firms and also the impact that profitability, solvency and indebtedness may have on their survival. We have used the Kaplan–Meier method in order to assess their survival and the Harrington–Fleming test and the Cox regression model to check the statistical significance of variables. These variables are key factors influencing the survival of cultural enterprises. Particularly, low solvency in firms increases by twenty the risk of disappearance. This paper contributes to literature highlighting some of the key factors for the survival of cultural enterprises. It provides administrations with a roadmap in order to implement measures for the promotion of the cultural industry, favouring the process of enhancement of cultural heritage.

Flow-Cytometry MRD Evaluation in Children with ALL; Can MRD Level on Day 33 Serve As a Surrogate Marker for Relapse?

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2401-2401
Author(s):  
Maria Ampatzidou ◽  
George Paterakis ◽  
Konstantinos Tsitsikas ◽  
Stephanos I. Papadhimitriou ◽  
Vassilios Papadakis ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Probability ◽  
Treatment Time ◽  
Risk Group ◽  
Surrogate Marker ◽  
Prognostic Impact ◽  
Log Reduction ◽  
Kaplan Meier ◽  
The Impact ◽  
The Relationship

Abstract Treatment-response assessment via quantification of MRD has become a corner-stone for risk stratification in childhood ALL. Although MRD has been shown to retain independent prognostic significance, the relationship with other prognostic variables has been incompletely explored. Moreover, determination of the most reliable treatment time-point for FCM-MRD evaluation that would serve as the best surrogate marker in predicting relapse, is still an issue of debate. To determine the utility of sequential measurements of FCM-MRD, with specific emphasis on day 33 and its correlation with known prognostic factors and outcome, we retrospectively analyzed the results of FCM-MRD study/data of 825 bone marrow samples of 133 children with ALL, at different treatment time-points, during induction and early consolidation (days 15, 33, 78, week 22-24, at start and at the end of maintenance therapy). All patients were homogeneously treated on BFM-based protocols and prognostic groups were defined by sex, WBC, prednisone response, risk-group allocation, immunophenotype and ETV6/RUNX1-presence. We investigated: a) the relationship between relapse probability and known prognostic factors like age, sex, WBC, immunophenotype, prednisone-response, ETV6/RUNX1 translocation, CDKN2A/2B deletion, hyperdiploidy, protocol risk-group, MRD(constant variable) and MRD positivity(≥0.1% vs <0.1%)(Kaplan-Meier and lïgrank test), b) the correlation between MRD(+) and outcome (OS and EFS, Kaplan-Meier). Additionally, multivariable Cox-models were used to determine the impact of MRD and WBC, sex, age, prednisone-response, on OS and EFS. Patients with MRD≥0.1% at the end of induction (day 33) were estimated with 5-year RFS rates of only 60.0±12.8%, compared to MRD low(<0.1%)/negative patients that enjoyed superior 5-year RFS rates of 91.3±3.0%. Both days 15 and 33 of FCM-MRD positivity maintained a significant prognostic impact on the incidence of relapse within all subgroups. MRD(+)d15 and MRD(+)d33 detection combined, appeared to have a statistically significant impact on survival probability (RFS 65.9%±10.6, p<0.001). Additionally, FCM-MRD on day 33 was notably more strongly associated with used prognostic factors, while we were able to demonstrate that FCM-MRD log-reduction rates between days 15 and 33 can also be added as an important relapse prediction marker, apart from absolute MRD quantifications. In our study, MRD(+)d15 and MRD(+)d33 in combination, strongly and statistically significant correlated with survival probability. Additionally, we propose the FCM-MRD log-reduction rate between days 15 and 33 and end-induction evaluation(day 33) as better predictors of survival and relapse probability, than only day 15 FCM-MRD estimations. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Beyond race: The impact of ethnicity on the treatment outcome of locally advanced head and neck cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16500-16500
Author(s):  
C. J. Calfa ◽  
M. Escalon ◽  
S. Zafar ◽  
E. Lopez ◽  
V. Patel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Head ◽  
Kaplan Meier ◽  
The Impact

16500 Background: Self identified racial groups share an unequal burden of head and neck cancer . Recent evidence suggests that outcome among races is different and the causes are multifactorial. Nonetheless, differences among ethnic groups have not been reported. Herein, we decided to analyze differences in treatment response and outcome among our white and Hispanic patient population treated for locally advanced head and neck cancer. Methods: Patients were identified using the tumor registry. We reviewed retrospectively the data from medical records. 100 white Hispanics (WH) and 50 white non-Hispanics (WNH) diagnosed with locally advanced head and neck cancer and treated at our institution from 2004 to 2005, were eligible for the study. Standard statistical analysis, including Kaplan-Meier survival curve and Cox proportional hazard models were used. P value of <0.05 was considered for statistical significance. Results: Preliminary results reveal that, in our study population, median age at diagnosis, gender, performance status (ECOG 0–2) and squamous cell histology did not differ significantly between the two groups. Stage 4 at diagnosis was more commonly observed in Hispanics as opposed to WNH (85.7% vs 68.6%) (P = 0.1). Surgery was more commonly used as an initial treatment option in Hispanics than WNH (42.8% vs 28.6%) (P = 0.18) while chemotherapy was less likely to be used (78.6% vs. 91.4%) (P = 0.15). Hispanics were more likely to smoke than WNH (P = 0.0003) and were equally exposed to chronic alcohol use. Patients from the Hispanic group were more likely to respond to therapy than whites by Chi-squared analysis but this difference was not statistically significant (P = 0.09). No differences were seen in disease free survival. Kaplan-Meier estimate of median overall survival was 16 months for Hispanics vs. 25 months for whites but this difference did not reach statistical significance (P = 0.26). Final analysis will be available at the time of the annual meeting. Conclusion: In our experience, a trend for decrease overall survival was noted in the Hispanic ethnic group. This may be in part due to more advanced stage at presentation. Nonetheless, in order to definitively answer this question, further research is warranted. No significant financial relationships to disclose.

Three fluoropyrimidine-based regimens in second-line therapy following nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer: Efficacy and tolerance in clinical practice.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 370-370
Author(s):  
Anne Laure Pointet ◽  
David Tougeron ◽  
Simon Pernot ◽  
Astrid Pozet ◽  
Dominique Bechade ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Statistical Significance ◽  
Performance Status ◽  
Locally Advanced ◽  
Rank Test ◽  
Line Treatment ◽  
Second Line ◽  
Secondary Resection ◽  
Kaplan Meier ◽  
Metastatic Sites

370 Background: Combination of nab-paclitaxel plus gemcitabine (N+G) has recently become a valid first-line treatment (1L) in metastatic pancreatic adenocarcinoma (MPA) in patients (pts) with performance status (PS) of 0,1 or 2, but there is currently no standard second-line treatment (2L) after this new 1L option. We evaluated survival outcomes and tolerability of three usual fluoropyrimidine-based regimens: FOLFOX, FOLFIRI or FOLFIRI.3 (FOLFIRI1/3), and FOLFIRINOX after N+G failure in MPA pts. Methods: We prospectively identified 138 pts from 11 French centers who received 1L N+G for unresectable pancreatic adenocarcinoma. After disease progression or unacceptable toxicity, we excluded pts with locally advanced cancer, or who underwent secondary resection/chemoradiotherapy. Three subgroups of 2L chemotherapy were identified: FOLFOX, FOLFIRI1/3 and FOLFIRINOX regimens. Response was evaluated by RECIST criteria, progression-free survivals (PFS1, PFS2), and overall survival (OS1, OS2) were calculated using Kaplan-Meier method and compared with the Log-rank test. Results: 61 pts with MPA received a 2L. Persistent neuropathy was present in 27% of pts. Median age was 71.7 years [41-83]. PS was 0, 1 or 2. Median 1L duration, number of metastatic sites, PS, CA19.9, albumin, and bilirubin levels, and persistent neuropathy grade were statistically comparable between the 3 subgroups. Median OS for all 2L pts was 6.0 months [4-8]. Third line regimen was used in 32.8% of 2L pts without statistical significance between the subgroups. Main grade 3/4 adverse events reported were thrombocytopenia (18%), anemia (7.7%), neutropenia (21.4%) and nausea (5.4%). No toxic deaths occurred. Conclusions: This study suggests a clinical benefit and a manageable toxicity profile of 2L fluoropyrimidine-based regimens after N+G failure in patients with MPA, in particularly combined with irinotecan.[Table: see text]

scholarly journals Obesity is associated with heavy menstruation that may be due to delayed endometrial repair

2021 ◽  
Vol 249 (2) ◽  
pp. 71-82
Author(s):  
Jane J Reavey ◽  
Catherine Walker ◽  
Alison A Murray ◽  
Savita Brito-Mutunayagam ◽  
Sheona Sweeney ◽  
...  
Keyword(s):  
Blood Loss ◽  
High Fat Diet ◽  
Statistical Significance ◽  
Surrogate Marker ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
High Fat ◽  
Mean Values ◽  
Diet Induced Obesity ◽  
The Impact

Heavy menstrual bleeding is common and debilitating but the causes remain ill defined. Rates of obesity in women are increasing and its impact on menstrual blood loss (MBL) is unknown. Therefore, we quantified BMI and MBL in women not taking hormones and with regular menstrual cycles and revealed a positive correlation. In a mouse model of simulated menstruation, diet-induced obesity also resulted in delayed endometrial repair, a surrogate marker for MBL. BrdU staining of mouse uterine tissue revealed decreased proliferation during menstruation in the luminal epithelium of mice on a high-fat diet. Menstruation is known to initiate local endometrial inflammation and endometrial hypoxia; hence, the impact of body weight on these processes was investigated. A panel of hypoxia-regulated genes (VEGF, ADM, LDHA, SLC2A1) showed consistently higher mean values in the endometrium of women with obesity and in uteri of mice with increased weight vs normal controls, although statistical significance was not reached. The inflammatory mediators, Tnf and Il6 were significantly increased in the uterus of mice on a high-fat diet, consistent with a pro-inflammatory local endometrial environment in these mice. In conclusion, obesity was associated with increased MBL in women. Mice given a high-fat diet had delayed endometrial repair at menstruation and provided a model in which to study the influence of obesity on menstrual physiology. Our results indicate that obesity results in a more pro-inflammatory local endometrial environment at menstruation, which may delay endometrial repair and increase menstrual blood loss.

Impact of income in stage IV prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 244-244
Author(s):  
Aabra Ahmed ◽  
Timothy Dean Malouff ◽  
Ryan W Walters ◽  
Sydney Marsh ◽  
Peter T. Silberstein
Keyword(s):  
Prostate Cancer ◽  
Median Survival ◽  
Statistical Significance ◽  
Stage Iv ◽  
Median Income ◽  
High School Degree ◽  
Kaplan Meier ◽  
Survival Differences ◽  
The Impact ◽  
Zip Code

244 Background: There is growing evidence of the impact of socioeconomic status on survival in cancer patients. To our knowledge, this is the largest study to examine demographics and the association between income and survival in patients with stage IV prostate cancer. Methods: Using the National Cancer Database, 50,639 patients diagnosed with stage IV prostate cancer between 2004-2011 were identified. Income was evaluated using the median income of the patient’s zip code. Between-income survival differences were estimated by the Kaplan-Meier method and associated log-rank tests; Tukey-Kramer adjusted p < .05 indicated statistical significance. Results: Survival differences were indicated between all income quartiles. Median survival was highest for patients in zip codes with a median income ≥ $63,000 and lowest for patients in zip codes with an income < $38,000 (46.1 months vs. 31.6 months, respectively; p < .001). As such, 41% of patients in zip codes with a median income ≥ $63,000 were alive five years following diagnosis, compared to 31% of patients in zip codes with median income < $38,000. Additionally, compared to patients in zip codes in which the median income was < $38,000, patients in zip codes with a median income ≥ $63,000 had a higher rate of zero comorbidities (81% vs. 76%), a greater percentage of patients living in an area where >93% people have a high school degree (58% vs 1%), and a lower proportion of African Americans (8% vs 41%). Conclusions: Compared to patients with a median income < $38,000, patients in zip codes with a median income > $63,000 had a median survival nearly 15 months longer, had 10% more patients alive after 5 years, and had fewer comorbidities. [Table: see text]

scholarly journals Prognostic factors and impact of peritoneal dialysis-related early peritonitis on mortality in Sardjito General Hospital, Yogyakarta, Indonesia

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Metalia Puspitasari ◽  
Heru Prasanto ◽  
Iri Kuswadi
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Prognostic Factors ◽  
Serum Creatinine ◽  
Early Onset ◽  
Late Onset ◽  
Lower Serum ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
The Impact

Background Peritonitis has been reported to be asso­ciated with high mortality. However, information on the impact of the first peritonitis episode on continu­ous ambulatory peritoneal dialysis (CAPD) patients is sparse. ObjectiveTo determine the association between peritoneal dialysis-related early peritonitis and mor­tality. To determine prognostic factors on mortality in peritonitis patients with peritoneal dialysis. Methods A retrospective observational cohort study was conducted over 5 years at a single PD unit in Sardjito Hospital. Inclusion criteria: First onset of peritonitis patients with peritoneal dialysis from 2013 -2017, age ≥ 18 years old. Exclusion criteria: Incomplete medical records. A total of 48 patients on CAPD with peritonitis was divided into the early onset of peritonitis (< 20 months) and late onset of peritonitis ( ≥ 20 months. Kaplan-Meier survival curve was used to display cumulative relative risk as a parameter of prognostic factors. Results A total of 48 patients (early onset of peritonitis, n = 31; late onset of peritonitis, n = 17) were analyzed in our study with a mean of age50.6 years consisted of males 64.6%. There was a significant difference in patients’ mortality between the early and late onset of peritoni­tis. The Kaplan-Meier analysis revealed that log-rank test, p<0.05 with a mean survival time of patients with early peritonitis and late peritonitis was 236 days (95% CI: 162-309 days) and 1702 days (95% CI: 1067-2338 days) consecutively. Compared to those who were nor­moweight, underweight or overweight patients had in­creased risk of mortality, (RR 1.14 and 1.15; p=0.003, respectively). There was a significant association be­tween diabetes mellitus and lower serum creatinine levels, and the risk of mortality (RR 1.43, p=0.03 and mean difference -6.01, p< 0.001, respectively). Conclusions Early peritonitis patients have a poor prognosis compared to the late peritonitis group. Pa­tients with shorter time to first peritonitis were prone to having a higher mortality rate. Diabetes mellitus, under­weight or overweight, and lower serum creatinine are prognostic factors of mortality in peritonitis patients.

Serum β2-Microglobulin Predicts Mortality in Peritoneal Dialysis Patients: A Prospective Cohort Study

2015 ◽  
Vol 42 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Eun Sil Koh ◽  
Kyungsoo Lee ◽  
Su Hyun Kim ◽  
Young Ok Kim ◽  
Dong Chan Jin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Surrogate Marker ◽  
Chronic Hemodialysis ◽  
Β2 Microglobulin ◽  
Kaplan Meier ◽  
Clinical Research Center ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Background/Aims: β2-Microglobulin (β2-M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum β2-M levels on mortality in peritoneal dialysis (PD) patients is uncertain. The purpose of this study was to examine the association of serum β2-M levels with all-cause mortality in PD patients. Methods: A total of 771 PD patients were selected from the Clinical Research Center registry for end-stage renal disease cohort in Korea. Patients were categorized into 3 groups by tertiles of serum β2-M levels. The primary outcome was all-cause mortality. Results: The median value of serum β2-M was 23.6 mg/l (interquartile range 14.8-33.4 mg/l), and the median follow-up period was 39 months. The Kaplan-Meier analysis showed that the all-cause mortality rate was significantly different according to tertiles of serum β2-M in PD patients (p = 0.03, log-rank). Multivariate Cox proportional analysis showed that the hazards ratio for all-cause mortality was 1.02 (95% CI 1.01-1.04, p = 0.006) per 1 mg/l increase in β2-M after adjustment for multiple confounding factors that relate to malnutrition and inflammation marker. However, serum β2-M was not associated with all-cause mortality after adjustment for residual renal clearance. Conclusions: These results are supportive of the potential role of the serum β2-M level as a predictor of mortality in PD patients.

An analysis of the National Cancer Database (NCDB): Immunotherapy and survival in stage III melanoma.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 159-159 ◽  
Author(s):  
Mridula Krishnan ◽  
Aabra Ahmed ◽  
Nabin Khanal ◽  
Peter T. Silberstein
Keyword(s):  
Statistical Significance ◽  
Private Insurance ◽  
Stage Iii ◽  
High Dose ◽  
Chi Square ◽  
Modest Improvement ◽  
Kaplan Meier ◽  
Stage Iii Melanoma ◽  
Chi Square Analysis ◽  
The Impact

159 Background: High dose Interferon (IFN) was the standard adjuvant treatment used for stage III melanoma between 2004-2010. To our knowledge, this is the largest study using the NCDB to determine the impact of immunotherapy used prior to 2011 in stage III melanoma. Methods: We identified 19,864 patients with stage III melanoma between 2004-2010. Among these, 5,406 of them received immunotherapy. Chi-square analysis was used to determine demographic differences between those with versus without immunotherapy. Between-therapy survival differences were estimated by the Kaplan-Meier method and associated log-rank tests; Tukey-Kramer adjusted p < 0.05 indicated statistical significance. Results: Patients who received immunotherapy had a mean survival of 89.8 months while those who did not had a mean survival of 71 months. The percentage of patients alive at 5 and 10 years was 62% and 52% (among those who received immunotherapy) compared to 46% and 32% (among those who did not receive immunotherapy) respectively. A much higher percentage of these patients were privately insured (73% vs. 47.1%, p<0.001). Those who received immunotherapy were more likely to be younger, have a higher income (36.2% vs. 34.8%, p<0.001), and a greater percentage of females received immunotherapy compared to males. (See Table 1.) Conclusions: Previously, Kirkwood et al. demonstrated a modest improvement in overall survival with IFN by 12 months (2.8 to 3.8 years). In our study, patients who received immunotherapy had a significant improvement in mean survival by 19 months. It was observed that patients who received immunotherapy were substantially younger, had private insurance and fewer comorbidities. [Table: see text]

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