{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:04:04Z","timestamp":1787162644680,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunotherapy for stage IV melanoma has dramatically changed the overall prognosis and treatment strategies. The aim of this study was to evaluate whether changes in systemic immunotherapy options have significantly altered surgical resection rates for patients with stage IV melanoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Cancer Database (2004\u20102015) was used to perform a difference\u2010in\u2010difference analysis to evaluate whether the rate of surgical resection of metastatic disease for stage IV melanoma differed with the use of immunotherapy in the checkpoint inhibitor era in comparison with the use of immunotherapy in the pre\u2013checkpoint inhibitor era. An adjusted difference\u2010in\u2010difference analysis stratified by facility type was performed. An adjusted Poisson regression analysis evaluated predictors of surgical resection in patients with stage IV melanoma who received immunotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 14,433 patients with stage IV melanoma (median age, 66\u00a0years [interquartile range, 56\u201076\u00a0years]; female, 31.7%), and of all patients in the checkpoint inhibitor era (n\u00a0=\u00a07,524), 25% (n\u00a0=\u00a01,879) received immunotherapy. Patients with stage IV disease who received immunotherapy in the checkpoint inhibitor era were more likely to be younger, be healthier, have private insurance, come from upper income quartiles, and be treated at academic programs. A difference\u2010in\u2010difference analysis revealed similar rates of surgical resection of metastatic disease with the use of immunotherapy in the checkpoint inhibitor era and the pre\u2013checkpoint inhibitor era, regardless of facility type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The distribution of immunotherapy was unequal among patients with stage IV melanoma. Across all facilities, the rates of surgical resection of metastatic disease for stage IV melanoma did not differ with the use of immunotherapy between the checkpoint inhibitor era and the pre\u2013checkpoint inhibitor era.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.32817","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T01:02:43Z","timestamp":1583888563000},"page":"2614-2624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Use of immunotherapy and surgery for stage IV melanoma"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-2121","authenticated-orcid":false,"given":"George","family":"Molina","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology Massachusetts General Hospital Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyulnara G.","family":"Kasumova","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-8308","authenticated-orcid":false,"given":"Motaz","family":"Qadan","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Massachusetts General Hospital Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Department of Surgery Newton Wellesley Hospital Newton Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve M.","family":"Boland","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Massachusetts General Hospital Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504030"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)70122-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1802357"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430210073013"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.11.001"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0658-4"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2014.12.006"},{"key":"e_1_2_8_10_1","volume-title":"Cutaneous Melanoma: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines)","author":"National Comprehensive Cancer Network","year":"2019"},{"key":"e_1_2_8_11_1","unstructured":"BelloDM PanageasKS HollmannTJ et al.Outcomes of patients with metastatic melanoma selected for surgery after immunotherapy. Paper presented at: Society of Surgical Oncology 2018 Annual Cancer Symposium; March 23 2018;Chicago Illinois."},{"key":"e_1_2_8_12_1","first-page":"2897","article-title":"Disparities of immunotherapy utilization in patients with stage III cutaneous melanoma: a national perspective","volume":"38","author":"Al\u2010Qurayshi Z","year":"2018","journal-title":"Anticancer Res"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25326"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2398-z"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26111"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-6072-3"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CMR.0000000000000032"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0459"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.32817","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.32817","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.32817","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.32817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:05:17Z","timestamp":1761869117000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.32817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,10]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1002\/cncr.32817"],"URL":"https:\/\/doi.org\/10.1002\/cncr.32817","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,10]]},"assertion":[{"value":"2019-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}