ABSTRACT
Background: Immunotherapy has revolutionized the treatment of patients with advanced melanoma as well as other cancers. Most studies, whether of interleukin-2 or checkpoint inhibitor therapies, have limited follow-up after 5 years, making the incidence of late relapses uncertain. In addition, the incidence of second primary melanomas in patients with stage IV melanoma treated with immunotherapy has rarely been reported. Methods: We performed a single-institution retrospective study of stage IV melanoma patients treated with interleukin-2 or checkpoint inhibitors over the period from 1992 to 2013. We found 59 patients alive and in remission 5 years after the beginning of immunotherapy and reviewed their subsequent clinical course. Results: This 59-patient cohort had a median follow-up of 13.1 years, with 36 patients followed up for at least 10 years. Four patients (6.8%) had relapses of their metastatic melanoma at 5, 8, 15, and 17 years after starting the successful immunotherapy. Three of the four are still alive. Only one patient in 690 patient-years of observation had a second primary invasive melanoma. Conclusion: Although late relapses after immunotherapy for melanoma do occur, we can conclude that the prognosis of stage IV melanoma patients in continuous remission 5 years after starting immunotherapy is excellent, with a progression-free survival of approximately 85% and a melanoma-specific survival of approximately 95% at 20 years in our series. Our incidence of second primary melanomas is lower than usually reported. These results have important implications regarding the follow-up of stage IV melanoma patients successfully treated with immunotherapy.
ABSTRACT
INTRODUCTION: Driver stress is a phenomenon many have studied in probably all five continents. It has been the focus of curiosity for all sorts of disciplines, and science has been unable to curb it, much less park it. OBJECTIVES: This study aims to generate a unique scale that can be used in Spanish speaking countries regardless of culture or geography. Method and Materials: A sample of 1954 drivers from Mexico, Guatemala, Costa Rica, Chile and Spain was comprised. Through this study, the original 21 items of the ISET (Stressful Situations in Transit Inventory, in Spanish) were used to carry out both an Exploratory Factorial Analysis as well as a Confirmatory Factorial Analysis. RESULTS: As a result, a 9 item scale was created that is valid for use in Spanish countries. CONCLUSIONS: Although further research is warranted, the LatinSET is now valid for its use in Spanish-speaking countries
INTRODUCCIÓN: El estrés en conductores es un fenómeno que muchos han estudiado en probablemente los cinco continentes del mundo. Ha sido el enfoque de estudio de una gran variedad de disciplinas, pero la ciencia no ha podido desgranarlo, ni mucho menos eliminarlo por completo. OBJETIVOS: Este estudio tiene como objetivo generar una nueva escala que pueda ser usada en países de habla hispana sin importar la cultura o la geografía. MATERIAL Y MÉTODOS: Una muestra de 1,954 conductores de México, Guatemala, Costa Rica, Chile y España fue recolectada. A través de este estudio, el juego original de 21 ítems del ISET (Inventario de Situaciones Estresantes en el Tránsito) fueron utilizados para llevar a cabo análisis factorial exploratorio y confirmatorio. RESULTADOS: Como resultado, una escala de 9 ítems fue creada que es válida para su uso en países hispanoparlantes. CONCLUSIONES: A pesar de que se requiere de más estudios relevantes, el LatinSET está listo para ser usado