Background/Objectives: To use natural language processing (NLP) to extract large-scale data from the CT radiology reports of patients with advanced melanoma treated with immunotherapy and to determine whether liver metastases affect survival.Methods: Patient criteria (M1 disease subclassified into M1a, M1b, or M1c) as well as alternative criteria (M1 with advanced melanoma, imaged with CT chest, abdomen, and pelvis from July 2014–March 2019) were included retrospectively. NLP was used to identify metastases from CT reports, and then patients were classified according to American Joint Committee on Cancer (AJCC) staging disease subclassified into M1L+ or M1L−, indicating whether liver metastases were present or not). Statistical analysis included constructing Kaplan–Meier survival curves and calculating hazard ratios (HRs).Results: 2239 patients were included (mean age, 63 years). Whether using AJCC or alternative criteria, overall survival (OS) was poorest for M1L+ (entire cohort median OS, 0.69 years [95% CI: 0.60–0.82]; immunotherapy cohort median OS, 1.4 years [95% CI: 0.92–2.0]) compared to M1L− (entire cohort median OS, 1.8 years [95% CI: 1.4–2.2]; immunotherapy cohort median OS; M1L−, 2.9 years [95% CI: 2.3–3.9]). The median HR for M1L+ (median HR, 5.35 [95% CI: 4.59–6.24]) was higher than that for M0 (p< 0.001). The median HR for M1L+ (median HR, 2.13 [95% CI: 1.65–2.64]) was higher than that for M0 (p< 0.01).Conclusions: Patients with advanced melanoma, particularly those with liver metastases, demonstrated inferior survival, even when treated with immunotherapy.
背景/目的：本研究旨在运用自然语言处理技术从接受免疫治疗的晚期黑色素瘤患者的CT影像报告中提取大规模数据，并探究肝转移是否影响患者生存期。 方法：回顾性纳入符合患者标准（M1期疾病细分为M1a、M1b或M1c亚型）及替代标准（2014年7月至2019年3月期间接受胸部、腹部及盆腔CT检查的晚期黑色素瘤M1期患者）。通过自然语言处理技术识别CT报告中的转移病灶，随后依据美国癌症联合委员会分期系统将患者划分为M1L+（存在肝转移）或M1L−（无肝转移）亚组。统计分析包括构建卡普兰-迈耶生存曲线及计算风险比。 结果：共纳入2239例患者（平均年龄63岁）。无论采用AJCC标准或替代标准，M1L+组患者总生存期均最差（全队列中位OS为0.69年[95% CI: 0.60–0.82]；免疫治疗亚组中位OS为1.4年[95% CI: 0.92–2.0]），显著低于M1L−组（全队列中位OS为1.8年[95% CI: 1.4–2.2]；免疫治疗亚组中位OS为2.9年[95% CI: 2.3–3.9]）。M1L+组中位风险比（5.35 [95% CI: 4.59–6.24]）显著高于M0组（p<0.001）；在免疫治疗亚组中，M1L+组中位风险比（2.13 [95% CI: 1.65–2.64]）亦显著高于M0组（p<0.01）。 结论：晚期黑色素瘤患者，特别是伴有肝转移者，即使接受免疫治疗仍表现出较差的生存预后。
肿瘤(癌症)患者之家