Evaluation of Racial, Ethnic, and Socioeconomic Associations With Treatment and Survival in Uveal Melanoma, 2004-2014

Rajeshuni, Nitya; Zubair, Talhah; Ludwig, Cassie A.; Moshfeghi, Darius M.; Mruthyunjaya, Prithvi

doi:10.1001/jamaophthalmol.2020.2254

Cited by 33 publications

(43 citation statements)

References 51 publications

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“…Although new techniques such as proton beam therapy have been introduced (5), plaque brachytherapy, mainly using iodine-125, remains the dominant option as an eyeball-conserving treatment for UM. In the United States, the ratio of plaque brachytherapy is increasing each year, which accounts for more than 50% recently (6,7). The same case was also seen in our eye center.…”

Section: Introductionsupporting

confidence: 76%

“…Patients who were diagnosed with UM at the Beijing Tongren Eye Center and subsequently received brachytherapy were included in this study. The exclusion criteria were: (1) age<18 years, (2) received other therapies, (3) alive and had a follow-up time of fewer than 4 years, (4) the third follow-up time was more than 3 years, (5) filled follow-up time was later than the time of outcome, (6) had metastatic disease at the time of diagnosis. Finally, 454 patients were included to construct the model for predicting death and 424 patients to build the model for predicting metastasis (Figure 2A).…”

Section: Selection Of Participantsmentioning

confidence: 99%

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Prognosis Prediction of Uveal Melanoma After Plaque Brachytherapy Based on Ultrasound With Machine Learning

et al. 2022

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IntroductionUveal melanoma (UM) is the most common intraocular malignancy in adults. Plaque brachytherapy remains the dominant eyeball-conserving therapy for UM. Tumor regression in UM after plaque brachytherapy has been reported as a valuable prognostic factor. The present study aimed to develop an accurate machine-learning model to predict the 4-year risk of metastasis and death in UM based on ocular ultrasound data.Material and MethodsA total of 454 patients with UM were enrolled in this retrospective, single-center study. All patients were followed up for at least 4 years after plaque brachytherapy and underwent ophthalmologic evaluations before the therapy. B-scan ultrasonography was used to measure the basal diameters and thickness of tumors preoperatively and postoperatively. Random Forest (RF) algorithm was used to construct two prediction models: whether a patient will survive for more than 4 years and whether the tumor will develop metastasis within 4 years after treatment.ResultsOur predictive model achieved an area under the receiver operating characteristic curve (AUC) of 0.708 for predicting death using only a one-time follow-up record. Including the data from two additional follow-ups increased the AUC of the model to 0.883. We attained AUCs of 0.730 and 0.846 with data from one and three-time follow-up, respectively, for predicting metastasis. The model found that the amount of postoperative follow-up data significantly improved death and metastasis prediction accuracy. Furthermore, we divided tumor treatment response into four patterns. The D(decrease)/S(stable) patterns are associated with a significantly better prognosis than the I(increase)/O(other) patterns.ConclusionsThe present study developed an RF model to predict the risk of metastasis and death from UM within 4 years based on ultrasound follow-up records following plaque brachytherapy. We intend to further validate our model in prospective datasets, enabling us to implement timely and efficient treatments.

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Section: Introductionsupporting

confidence: 76%

Section: Selection Of Participantsmentioning

confidence: 99%

Prognosis Prediction of Uveal Melanoma After Plaque Brachytherapy Based on Ultrasound With Machine Learning

et al. 2022

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“…Rajeshuni et al made evaluation of socioeconomic associations with treatment and survival in UM. The results showed that socioeconomically disadvantaged patients with UM are more likely to be treated with primary enucleation and also revealed opportunities to address issues regarding treatment choice in UM, which was a merit point in this work [ 36 ]. However, no study has emphasized the influence of marital status on UM patients or has conducted subgroup analysis stratified by sex and SEER stage.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Marital Status on the Survival of Patients with Uveal Melanoma

Cai

Fan

Shen

et al. 2020

Journal of Ophthalmology

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Background. Uveal melanoma (UM) is the most common primary intraocular tumor in adults and arises from the uvea. Marital status was a vital factor among physical conditions and social networks of cancer patients. Our study aimed to evaluate the impact of marital status on the outcomes among patients with UM. Methods. Patients with UM newly diagnosed from 2004 to 2015 were extracted, and the data were extracted from Surveillance, Epidemiology, and End Results (SEER) program. Overall survival (OS) was measured via the log-rank test, as well as cancer-specific survival (CSS) was also calculated via the same method. Cox proportional hazards models were applied to assess whether marital status was related to both OS and CSS. Furthermore, we performed subgroup analysis depending on different sexes and SEER stages. Results. In total, 4217 eligible patients were involved. Of these patients, 66.2% (n = 2793) were married, 14.6% (n = 615) were single, and 9.0% (n = 379) were divorced or separated, as well as widowed were 10.2% (n = 430). The 5-year OS of married, single, divorced or separated, and widowed patients was 74.0%, 72.8%, 68.6%, and 55.8%, respectively. The results indicating better OS and CSS occurred among married patients. Other factors such as sex, age at diagnosis, and SEER stage were also correlated with survival in UM patients. Furthermore, subgroup analyses were consistent with the results above. Conclusion. Marital status was proved to be an independent prognostic value for survival in UM patients. In addition, contrast to married patients, widowed individuals showed poor OS and CSS at different subgroup analyses.

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“…It has been established that race and SES affect overall and disease-specific mortality for cancer in general, so we hypothesized that race, ethnicity, and SES would similarly impact the DSS and CDSS of NPC . 13 14 15 16 Findings from this study could help to identify potentially modifiable variables that determine survival and prognosis for NPC.…”

Section: Introductionmentioning

confidence: 95%

“…Several studies have illustrated the validity of the Yost Index in cancer-related outcomes. 13 14 15 16…”

Section: Introductionmentioning

confidence: 99%

Impact of Race, Ethnicity, and Socioeconomic Status on Nasopharyngeal Carcinoma Disease-Specific and Conditional Survival

London

Gallagher

Sharma

et al. 2021

J Neurol Surg B Skull Base

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Introduction Race, ethnicity, and socioeconomic status (SES) are complex, interconnected social determinants of health outcomes. This study uses multivariable analysis on a combination of large national datasets to examine the effects of these factors on 5-year disease-specific survival (DSS) and conditional DSS (CDSS) for nasopharyngeal carcinoma (NPC). Methods A retrospective study of adults with NPC between 2000 and 2017 from the Surveillance, Epidemiology, End Results (SEER) registry was performed, using the National Cancer Institute Yost Index, a census tract–level composite score of SES to categorize patients. Kaplan–Meier analysis and Cox's regression for DSS and CDSS were stratified by SES. Logistic regression was conducted to identify risk factors for advanced cancer stage at time of diagnosis and receiving multimodal therapy. Results Our analysis included 5,632 patients. DSS was significantly associated with race and SES (p < 0.01). Asian/Pacific Islander patients exhibited increased survival when controlling for other variables (hazard ratio [HR] = 0.73, p < 0.01). Although Black patients were more likely to be diagnosed with advanced disease (Black odds ratio [OR] = 1.47, p < 0.01), Black patients were also less likely to receive multimodal therapy; however, this relationship lost statistical significance once SES was incorporated into the multivariable analysis. DSS was decreased among the lowest (first) and middle (second) tertiles of SES (first HR = 1.34, p < 0.01; second HR = 1.20, p < 0.01) compared with the highest (third). Conclusion Our results indicate that race, ethnicity, and SES significantly affect survival, stage at diagnosis, and treatment of NPC. An interplay of tumor biology and inequalities in access to care likely drives these disparities.

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Evaluation of Racial, Ethnic, and Socioeconomic Associations With Treatment and Survival in Uveal Melanoma, 2004-2014

Cited by 33 publications

References 51 publications

Prognosis Prediction of Uveal Melanoma After Plaque Brachytherapy Based on Ultrasound With Machine Learning

Prognosis Prediction of Uveal Melanoma After Plaque Brachytherapy Based on Ultrasound With Machine Learning

The Influence of Marital Status on the Survival of Patients with Uveal Melanoma

Impact of Race, Ethnicity, and Socioeconomic Status on Nasopharyngeal Carcinoma Disease-Specific and Conditional Survival

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