作者: Zhang, Yichen ; Fraile, Belen ; Wang, David M ; Ruiz, Emily Stamell ; Ott, Patrick A ; Karia, Pritesh S ; Lin, Jennifer Y ; Schmults, Chrysalyne D ; Duran, Juanita ; Morgan, Frederick C

BACKGROUNDTemporal analyses of skin cancer costs are needed to examine how expenditure differences between diagnoses are changing.OBJECTIVETo tabulate the costs of skin cancer-related care (SCRC), including both screening and treatment, at an academic cancer center at 2 time points.METHODSCost data (insurance and patient payments) at an academic cancer center from 2008 and 2013 were queried for International Classification of Diseases, Ninth Revision, codes pertaining to skin cancer. Screening costs were separated from treatment costs through associated Current Procedural Terminology codes.RESULTSThe total annual cost of SCRC increased by 64%, the number of patients receiving SCRC increased by 45%, and the mean cost per patient treated increased by 13%. Screening accounted for 17% and 16% of total annual costs in 2008 and 2013, respectively. The mean cost per patient with melanoma increased by 84%, which was the largest increase among skin cancer diagnoses. In 2013, the few patients with melanoma who were treated with ipilimumab (n = 48 [4% of patients with melanoma]) accounted for 42% of melanoma treatment costs and 20% of SCRC costs.LIMITATIONSPrescription costs were unavailable.CONCLUSIONSMelanoma costs have increased as a result of the introduction of ipilimumab. Ongoing studies are needed to monitor the cost-effectiveness of SCRC at a national level.

2003-04-01·Annals of Surgical Oncology2区 · 医学

Cyclooxygenase-2 Inhibition Improves Macrophage Function in Melanoma and Increases the Antineoplastic Activity of Interferon ?

2区 · 医学

Article

作者: John M. Daly ; Tracy A. Freeman ; Philip P. Stapleton ; Gordon P. Smyth ; Sirish Maddali ; Juan R. Mestre ; Michael Duff ; Zhaoping Yan

BACKGROUNDMelanoma inhibits macrophage tumoricidal activity and increases the expression of cyclooxygenase-2 (COX-2). In this study, we sought to determine whether inhibition of COX-2 could restore macrophage function and hence maximize the antitumor activity of the immune stimulant interferon gamma (IFN gamma).METHODSPeritoneal macrophages were exposed to B16 melanoma-conditioned medium for 24 hours with or without the COX-2 inhibitor NS-398 and then were stimulated with lipopolysaccharide and IFN gamma. Cytotoxic activity, nitrite production, and cytokine production by the stimulated macrophages were measured. In addition, B16 melanoma cells were implanted intradermally into mice treated with IFN gamma (14,000 U on alternate days) alone or with a combination of IFN gamma and a COX-2 inhibitor (NS-398 or nimesulide). Mice were assessed for tumor growth and survival.RESULTSMacrophage cytotoxicity and nitrite production were significantly suppressed by melanoma-conditioned medium (P <.01). This was prevented by 200 micro M of NS-398 (P <.05). In vivo, combined treatment with IFN gamma and a COX-2 inhibitor caused a significant inhibition of tumor growth (P <.01) and improved survival (P =.02) compared with controls.CONCLUSIONSCOX-2 inhibition reversed melanoma-induced suppression of macrophage function, and combined treatment of IFN gamma plus a COX-2 inhibitor was maximally effective in reducing tumor growth and improving survival.

1998-09-01·Ophthalmology1区 · 医学

Long-term survival in choroidal and ciliary body melanoma after enucleation versus plaque radiation therapy

1区 · 医学

Article

作者: Jorge Freire ; Zélia M Corrêa ; James J Augsburger ; Luther W Brady

OBJECTIVEThis study aimed to determine whether the long-term melanoma-specific mortality rate of patients with a primary choroidal or ciliary body melanoma treated by enucleation is appreciably lower than that of similar patients treated by plaque radiation therapy.DESIGNRetrospective, nonrandomized, comparative clinical trial.PARTICIPANTSA previously reported group of 237 patients, 140 treated by enucleation and 97 treated by cobalt-60 (Co-60) plaque between May 1976 and June 1980, and a residual group of 122 patients, 51 treated by enucleation and 71 treated by Co-60 plaque, were identified by variable-by-variable range matching.INTERVENTIONPrimary treatment by enucleation or Co-60 plaque radiation therapy was performed.MAIN OUTCOME MEASURESMelanoma-specific mortality and duration of post-treatment survival were measured.RESULTSThe melanoma-specific mortality rate was substantially worse in the original enucleation subgroup over the entire 15-year follow-up interval; however, differences in baseline prognostic factors between the subgroups are likely to explain the difference in survival curves. After elimination of patients with nonoverlapping values of individual clinical variables to adjust for recognized intergroup differences at baseline, there was no significant or clinically important difference in the 15-year mortality curves of the residual subgroups. The relative rate ratio for the treatment effect in the residual patients was 0.97 (95% confidence interval, 0.51-1.86). There was no late downturn in the survival curve of the plaque-treated patients or late crossing of the curves.CONCLUSIONA large difference in survival between equivalent groups of patients with primary choroidal or ciliary body melanoma treated by enucleation versus plaque radiation therapy appears to be unlikely.

100 项与 Melanoma(Theravectys) 相关的药物交易

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