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Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma

INTRODUCTION: Real-world data on recurrence and economic burden in patients with resected early-stage melanoma are limited. The objective of this study was to assess real-world recurrence rates, risk factors for recurrence, and costs of recurrence in patients with resected stage IIB, IIC, or IIIA me...

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Autores principales: Jang, Sekwon, Poretta, Tayla, Bhagnani, Tarun, Harshaw, Qing, Burke, Matthew, Rao, Sumati
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477064/
https://www.ncbi.nlm.nih.gov/pubmed/32548707
http://dx.doi.org/10.1007/s13555-020-00404-9
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author Jang, Sekwon
Poretta, Tayla
Bhagnani, Tarun
Harshaw, Qing
Burke, Matthew
Rao, Sumati
author_facet Jang, Sekwon
Poretta, Tayla
Bhagnani, Tarun
Harshaw, Qing
Burke, Matthew
Rao, Sumati
author_sort Jang, Sekwon
collection PubMed
description INTRODUCTION: Real-world data on recurrence and economic burden in patients with resected early-stage melanoma are limited. The objective of this study was to assess real-world recurrence rates, risk factors for recurrence, and costs of recurrence in patients with resected stage IIB, IIC, or IIIA melanoma in the USA. METHODS: This retrospective analysis included patients with resected stage IIB, IIC, or IIIA melanoma (American Joint Committee on Cancer staging manual, seventh edition) in the Surveillance, Epidemiology, and End Results (SEER) program–Medicare database of the National Cancer Institute. Recurrence rates and healthcare costs (2018 USD) after recurrence were assessed. RESULTS: Two-year recurrence rates for stages IIB, IIC, and IIIA melanoma were 29, 44, and 46%, respectively. In patients with stage IIB or IIC disease, the odds of recurrence were significantly higher in those aged > 75 years [odds ratio (OR) 1.853, 95% confidence interval (CI) 1.416, 2.425], with ulceration (OR 1.771; 95% CI 1.293, 2.425), or with a higher Charlson Comorbidity Index (OR 1.244; 95% CI 1.129, 1.372); however, the odds of recurrence were significantly lower in those with T3 staging (OR 0.522; 95% CI  0.393, 0.695). In those with stage IIIA melanoma, superficial spreading was associated with significantly lower odds of recurrence (OR 0.178; 95% CI 0.053, 0.601). Following recurrence, mean healthcare costs at 1 year were $31,870 for patients with stage IIB or IIC melanoma and $29,224 for those with stage IIIA melanoma. CONCLUSION: The SEER data show that a substantial proportion of adults with early-stage melanoma experience a recurrence within 2 years following resection, resulting in a significant economic burden to the US healthcare system. Dermatologists can distinguish patients with resected early-stage melanoma who are at a high risk for recurrence and consider referrals to medical oncologists for approved adjuvant therapy or enrollment in clinical trials after surgical resection to reduce the recurrence of melanoma.
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spelling pubmed-74770642020-09-18 Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma Jang, Sekwon Poretta, Tayla Bhagnani, Tarun Harshaw, Qing Burke, Matthew Rao, Sumati Dermatol Ther (Heidelb) Original Research INTRODUCTION: Real-world data on recurrence and economic burden in patients with resected early-stage melanoma are limited. The objective of this study was to assess real-world recurrence rates, risk factors for recurrence, and costs of recurrence in patients with resected stage IIB, IIC, or IIIA melanoma in the USA. METHODS: This retrospective analysis included patients with resected stage IIB, IIC, or IIIA melanoma (American Joint Committee on Cancer staging manual, seventh edition) in the Surveillance, Epidemiology, and End Results (SEER) program–Medicare database of the National Cancer Institute. Recurrence rates and healthcare costs (2018 USD) after recurrence were assessed. RESULTS: Two-year recurrence rates for stages IIB, IIC, and IIIA melanoma were 29, 44, and 46%, respectively. In patients with stage IIB or IIC disease, the odds of recurrence were significantly higher in those aged > 75 years [odds ratio (OR) 1.853, 95% confidence interval (CI) 1.416, 2.425], with ulceration (OR 1.771; 95% CI 1.293, 2.425), or with a higher Charlson Comorbidity Index (OR 1.244; 95% CI 1.129, 1.372); however, the odds of recurrence were significantly lower in those with T3 staging (OR 0.522; 95% CI  0.393, 0.695). In those with stage IIIA melanoma, superficial spreading was associated with significantly lower odds of recurrence (OR 0.178; 95% CI 0.053, 0.601). Following recurrence, mean healthcare costs at 1 year were $31,870 for patients with stage IIB or IIC melanoma and $29,224 for those with stage IIIA melanoma. CONCLUSION: The SEER data show that a substantial proportion of adults with early-stage melanoma experience a recurrence within 2 years following resection, resulting in a significant economic burden to the US healthcare system. Dermatologists can distinguish patients with resected early-stage melanoma who are at a high risk for recurrence and consider referrals to medical oncologists for approved adjuvant therapy or enrollment in clinical trials after surgical resection to reduce the recurrence of melanoma. Springer Healthcare 2020-06-16 /pmc/articles/PMC7477064/ /pubmed/32548707 http://dx.doi.org/10.1007/s13555-020-00404-9 Text en © The Author(s) 2020, corrected publication 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Jang, Sekwon
Poretta, Tayla
Bhagnani, Tarun
Harshaw, Qing
Burke, Matthew
Rao, Sumati
Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title_full Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title_fullStr Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title_full_unstemmed Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title_short Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma
title_sort real-world recurrence rates and economic burden in patients with resected early-stage melanoma
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477064/
https://www.ncbi.nlm.nih.gov/pubmed/32548707
http://dx.doi.org/10.1007/s13555-020-00404-9
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