American journal of surgery · 2025
Male or female sex stratified by age does not impact survival in patients with metastatic melanoma receiving immunotherapy.
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Keller Hilary R, Hanes Douglas A, Lascano Danny, McCabe Jillian K, Shin Paul, Goldfarb Melanie, Essner Richard
Аннотация
BACKGROUND: Increasing age and male sex are associated with worse prognosis in melanoma. Here, we evaluated outcomes in stage IV melanoma patients who received immunotherapy, stratified by sex and age.
METHODS: The National Cancer Database (NCDB) was queried to identify patients with stage IV melanoma (n = 20023) with or without first-course immunotherapy from 2012 to 2019.
RESULTS: 67.7 % of patients were male, and 44.2 % received immunotherapy. On multivariable analysis, when compared to males, female patients had improved survival without immunotherapy (HR 0.90, p < 0.001), but survival was equivalent with immunotherapy (HR 0.95, p = 0.106). The benefit of immunotherapy was smaller in females compared to males overall (HR 1.08, p = 0.039), and greater in patients aged 45-60 years (HR 0.82, p = 0.006) or >60 years (HR 0.84, p = 0.008), relative to 18-44-year-olds.
CONCLUSIONS: Survival outcomes between male and female metastatic melanoma patients were equivalent when receiving immunotherapy. The benefit of immunotherapy was greatest in those aged >45 years, regardless of sex.
METHODS: The National Cancer Database (NCDB) was queried to identify patients with stage IV melanoma (n = 20023) with or without first-course immunotherapy from 2012 to 2019.
RESULTS: 67.7 % of patients were male, and 44.2 % received immunotherapy. On multivariable analysis, when compared to males, female patients had improved survival without immunotherapy (HR 0.90, p < 0.001), but survival was equivalent with immunotherapy (HR 0.95, p = 0.106). The benefit of immunotherapy was smaller in females compared to males overall (HR 1.08, p = 0.039), and greater in patients aged 45-60 years (HR 0.82, p = 0.006) or >60 years (HR 0.84, p = 0.008), relative to 18-44-year-olds.
CONCLUSIONS: Survival outcomes between male and female metastatic melanoma patients were equivalent when receiving immunotherapy. The benefit of immunotherapy was greatest in those aged >45 years, regardless of sex.