Fiche publication
Date publication
mars 2017
Journal
Haematologica
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MAYNADIE Marc
Tous les auteurs :
Le Guyader-Peyrou S, Orazio S, Dejardin O, Maynadié M, Troussard X, Monnereau A
Lien Pubmed
Résumé
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.
Mots clés
Adolescent, Adult, Aged, Aged, 80 and over, Child, Comorbidity, Factor Analysis, Statistical, Female, France, epidemiology, Humans, Lymphoma, Large B-Cell, Diffuse, epidemiology, Male, Middle Aged, Patient Outcome Assessment, Population Surveillance, Prognosis, Registries, Social Class, Survival Analysis, Young Adult
Référence
Haematologica. 2017 Mar;102(3):584-592
