Abstract 4768: Characteristics of patients diagnosed de novo with AJCC7 stage III or regionally advanced cutaneous melanoma and trends in adjuvant therapy: An analysis of the SEER cancer registry in the United States
Notice bibliographique
Résumé
Abstract Background: The v1.2018 National Comprehensive Cancer Network guidelines adopted nivolumab and dabrafenib/trametinib as potential adjuvant therapies for selected patients (pts) with AJCC7 stage III/regionally advanced melanoma. There is a need to understand which patient characteristics may affect adjuvant treatment choices and what lessons can be learned from the era of adjuvant interferon-alfa and ipilimumab. This study aimed to describe characteristics and use of adjuvant therapy in pts with stage III/regional melanoma. Methods: Pts newly diagnosed with invasive melanoma were identified in the US Surveillance, Epidemiology, and End Results (SEER) cancer registry (most recent 5 years: 2010 -2014; n = 106,195). Stage III melanoma was defined based on the AJCC7 classification (n = 7,669); pts classified as AJCC7 stages I/II but with reported lymphatic metastasis were considered regionally advanced and included (n =169). Pt characteristics measured at the time of the diagnosis are reported by treatments (systemic and radiation) initiated as the main course of treatment in the 4 months post-diagnosis. Results: Of 7,838 pts with stage III/regional disease at diagnosis from 2010-2014, 1,414 (18.0%) received radiation therapy (± systemic), 1,001 (12.8%) received systemic therapy (± radiation), 443 (5.7%) received radiation + systemic therapy, and 5,866 (74.8%) were not treated with either radiation or systemic therapy. Table 1 reports selected patient characteristics by treatment received. Conclusions: The results of this study indicate that many pts with stage III/regional melanoma, even those not treated, have risk factors known to be associated with worse prognosis. Use of radiation therapy or adjuvant systemic therapy was rare during the study period (2010-2014). It remains to be determined how the new treatment landscape will change the use of adjuvant therapy. Table 1.Stage III1/regionally advanced melanomaRadiation (± systemic)(n =1,414 )Systemic (± radiation) (n = 1,001)Systemic + radiation (n = 443)Neither2 (n =5,866 )Age at diagnosis, median (Q1-Q3)65 (55 - 76)58 (48 - 68)61 (51 - 71)62 (51 - 73)Males, %57.351.174.337.6LN classification (from TNM), %N145.347.545.461.9N2 (includes N2c)35.334.139.726.7N319.118.114.011.4Ulceration, %Yes20.325.29.339.0No22.824.38.846.3Unknown56.950.581.914.7Number mitoses per square mm, %None1.62.70.94.71 - 514.818.84.539.3≥ 615.018.27.924.3Unknown68.660.386.731.7LN involvement (any), %91.494.091.693.91 LN33.637.431.857.72 - 3 LNs25.326.323.922.5> 3 LNs19.216.818.57.5Unknown number of LNs13.313.617.46.2Microscopic nodal metastasis3 (regardless of the number of LNs)20.231.28.861.7Satellite / in-transit without LN involvement (N2c), %5.32.62.55.2LN, lymph node; TNM, tumor/node/metastasis (TNM) classification of malignant tumors. [1] Stage III melanoma was defined based on the American Joint Committee on Cancer (AJCC) 7 edition classification; [2] Radiation therapy and chemotherapy are reported in the SEER with moderate sensitivity (80% and 68%, respectively) and high specificity. This implies the "Neither" category may include some false -negative (i.e., treated) pts.[3] Includes pts identified with clinically occult (microscopic) LN metastases only, pts with isolated tumor cells only in LN, and/or pts who underwent sentinel LN biopsy and were found to have LN metastasis. Citation Format: Ahmad Tarhini, Sameer Ghate, Antonio Nakasato, Raluca Ionescu-Ittu, Sherry Shi, Briana Ndife, Rebecca Burne, François Laliberté, Mei S. Duh. Characteristics of patients diagnosed de novo with AJCC7 stage III or regionally advanced cutaneous melanoma and trends in adjuvant therapy: An analysis of the SEER cancer registry in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4768.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».