{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:48:59Z","timestamp":1784634539438,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>IO has transformed cancer management, but its adoption in advanced cancer patients varies by tumor type. With more Stage IV patients undergoing surgery, understanding site\u2010specific outcomes in these challenging patients is essential. We aimed to evaluate IO use and survival trends for Stage IV cancer patients across high\u2010incidence cancers in the US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with Stage IV prostate, breast, melanoma, colorectal, renal, bladder, lung, or pancreas cancer were identified from the National Cancer Database (2004\u20132020). Cochrane\u2013Armitage test and Kaplan\u2013Meier methods assessed IO and overall survival across three periods: 2004\u20132010, 2011\u20132015, and 2016\u20132020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1\u2009425\u2009731 Stage IV cancer patients, most had lung (50.0%), pancreas (12.5%), and breast cancer (9.3%), while the least had melanoma (2.2%). From periods 1 to 3, IO use increased from 1.0% to 24.6%, notably in melanoma (9.5% to 58.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Melanoma exhibited the greatest survival gains (median survival: 7.1 to 14.9 months). Absolute increases in 3\u2010year overall survival rates ranged from 3.4% in pancreas (1.7% to 5.1%) to 21.4% in melanoma (15.7% to 37.1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Utilization of IO is tumor\u2010site specific and associated with improved survival rates for Stage IV cancer, with varied success across types. Variations in receipt highlight ongoing challenges to ensure equitable adoption.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.28084","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T05:08:01Z","timestamp":1736831281000},"page":"1455-1466","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Trends in Immunotherapy (IO) Use and Survival Among Patients With High\u2010Incidence Stage IV Cancers Across the United States"],"prefix":"10.1002","volume":"131","author":[{"given":"Samantha C.","family":"Warwar","sequence":"first","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Northwestern Quality Improvement, Research, &amp; Education in Surgery (NQUIRES) Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Janczewski","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Northwestern Quality Improvement, Research, &amp; Education in Surgery (NQUIRES) Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys M.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Wayne","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Robert H. Lurie Comprehensive Cancer Center Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2506-6187","authenticated-orcid":false,"given":"David J.","family":"Bentrem","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Northwestern Quality Improvement, Research, &amp; Education in Surgery (NQUIRES) Northwestern University Feinberg School of Medicine Chicago Illinois USA"},{"name":"Robert H. 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