Conditional Survival: An Assessment of the Prognosis of Patients at Time Points After Initial Diagnosis and Treatment of Locoregional Melanoma Metastasis
| Autor: | Lauren E. Haydu, Jonathan R. Stretch, Serigne Lo, Richard A. Scolyer, Robyn P. M. Saw, William H. McCarthy, Andrew J. Spillane, Kerwin F. Shannon, John F. Thompson, Michael J. Quinn |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Adolescent Metastasis Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Survivorship curve medicine Humans Stage IIIC Neoplasm Metastasis Stage (cooking) Young adult Child Melanoma Aged Neoplasm Staging Proportional Hazards Models Cancer staging Aged 80 and over Proportional hazards model business.industry Cancer Middle Aged Prognosis medicine.disease Surgery 030104 developmental biology Chemotherapy Adjuvant Child Preschool 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local business |
| Zdroj: | Journal of Clinical Oncology. 35:1721-1729 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2016.71.9393 |
| Popis: | Purpose Standard cancer staging and prognostic estimates are determined at the time of the patient’s initial disease presentation. Conditional survival is an alternative, dynamic assessment from follow-up time points after the initial disease diagnosis and is based on the condition of survivorship. Estimates of conditional survival can provide critical prognostic information for patients and clinicians, guide subsequent cancer follow-up schedules, and influence decisions regarding treatments. The current study presents conditional survival estimates developed from a cohort of 4,540 patients diagnosed with stage III melanoma treated at a single institution. Methods Patients with stage III disease at first melanoma diagnosis (initial; n = 2,042), or who developed locoregional metastasis as a first recurrence some time after primary diagnosis (recurrent; n = 2,498), were assessed. Conditional melanoma-specific survival (MSS) estimates up to 5 years after diagnosis were adjusted for age, sex, and 8th edition American Joint Committee on Cancer (AJCC) stage. Results Older age at diagnosis of stage III disease conveyed a worse prognosis at each conditional survival time point. Males had significantly worse MSS outcomes for up to 2 years of conditional survival, after which males and females had similar MSS. For patients with AJCC stage IIIB and stage IIIC disease, MSS outcomes were similar to those of patients with stage IIIA disease after 3 and 5 years of survivorship, respectively. Conclusion Adjuvant systemic treatments may have the greatest benefit when administered within the first 2 years of stage III melanoma diagnosis, during which period prognosis is significantly worse for male patients of increasing age and AJCC substage. Conditional survival estimates illustrate improved survival prospects for patients with cancer returning for follow-up and may define a finite period of increased risk after diagnosis. |
| Databáze: | OpenAIRE |
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