1. Factors related to the relative survival of patients with diffuse large B-cell lymphoma in a population-based study in France: does socio-economic status have a role?
- Author
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Alain Monnereau, Sébastien Orazio, Olivier Dejardin, Sandra Le Guyader-Peyrou, Marc Maynadié, Xavier Troussard, Registre des hémopathies malignes de la Gironde, Institut Bergonié - CRLCC Bordeaux, Cancer environnement ( EPICENE ), Bordeaux population health ( BPH ), Université de Bordeaux ( UB ) -Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bordeaux ( UB ) -Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Cancers et préventions, Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Registre des hémopathies malignes de Côte d'Or, Registre des hémopathies malignes de Basse-Normandie, CHU Caen, Laboratoire d'hématologie biologique [Caen], Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Caen, Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Registre des hémopathies malignes de Basse-Normandie [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Laboratoire d'Hématologie Biologique [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), université de Bourgogne, LNC, and Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology ,Male ,0301 basic medicine ,Pediatrics ,Multivariate analysis ,MESH: Registries ,MESH : Aged ,MESH: Comorbidity ,Comorbidity ,MESH : Lymphoma, Large B-Cell, Diffuse ,MESH: Aged, 80 and over ,0302 clinical medicine ,International Prognostic Index ,MESH : Child ,MESH: Child ,MESH : Population Surveillance ,[ SDV.MHEP.HEM ] Life Sciences [q-bio]/Human health and pathology/Hematology ,MESH : Female ,Registries ,Young adult ,Child ,Aged, 80 and over ,MESH: Aged ,MESH: Middle Aged ,MESH : Prognosis ,Relative survival ,MESH: Patient Outcome Assessment ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,Articles ,Hematology ,Middle Aged ,MESH : Adult ,Prognosis ,MESH : Patient Outcome Assessment ,3. Good health ,MESH: Young Adult ,Population Surveillance ,MESH: Survival Analysis ,030220 oncology & carcinogenesis ,MESH : Comorbidity ,Marital status ,Female ,France ,Lymphoma, Large B-Cell, Diffuse ,Non-Hodgkin Leukemia ,Adult ,medicine.medical_specialty ,Adolescent ,MESH : Male ,MESH: Factor Analysis, Statistical ,MESH : Young Adult ,MESH : Factor Analysis, Statistical ,MESH: Prognosis ,MESH: Population Surveillance ,MESH: Social Class ,Young Adult ,03 medical and health sciences ,MESH : Adolescent ,Internal medicine ,MESH : Social Class ,medicine ,Humans ,MESH : Middle Aged ,MESH : Aged, 80 and over ,MESH : France ,Survival analysis ,Aged ,MESH: Adolescent ,MESH: Humans ,business.industry ,MESH : Humans ,MESH: Adult ,medicine.disease ,Survival Analysis ,MESH: Male ,Patient Outcome Assessment ,MESH: France ,030104 developmental biology ,Social Class ,MESH: Lymphoma, Large B-Cell, Diffuse ,MESH : Survival Analysis ,Factor Analysis, Statistical ,business ,MESH: Female ,Diffuse large B-cell lymphoma ,MESH : Registries - Abstract
IF 7.702; International audience; The survival of patients with diffuse large B-cell lymphoma has increased during the last decade as a result of addition of anti-CD20 to anthracycline-based chemotherapy. Although the trend is encouraging, there are persistent differences in survival within and between the USA and European countries suggesting that non-biological factors play a role. Our aim was to investigate the influence of such factors on relative survival of patients with diffuse large B-cell lymphoma. We conducted a retrospective, multicenter, registry-based study in France on 1165 incident cases of diffuse large B-cell lymphoma between 2002 and 2008. Relative survival analyses were performed and missing data were controlled with the multiple imputation method. In a multivariate analysis, adjusted for age, sex and International Prognostic Index, we confirmed that time period was associated with a better 5-year relative survival. The registry area, the medical specialty of the care department (onco-hematology versus other), the time to travel to the nearest teaching hospital, the place of treatment (teaching versus not-teaching hospital -borderline significance), a comorbidity burden and marital status were independently associated with the 5-year relative survival. Adjusted for first-course treatment, inclusion in a clinical trial and treatment discussion in a multidisciplinary meeting were strongly associated with a better survival outcome. In contrast, socio-economic status (determined using the European Deprivation Index) was not associated with outcome. Despite therapeutic advances, various non-biological factors affected the relative survival of patients with diffuse large B-cell lymphoma. The notion of lymphoma-specific expertise seems to be essential to achieve optimal care management and reopens the debate regarding centralization of these patients' care in hematology/oncology departments.
- Published
- 2016
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