- Sandra Le Guyader-Peyrou1,*,
- Sebastien Orazio1,
- Olivier Dejardin2,
- Marc Maynadie1,
- Xavier Troussard1 and
- Alain Monnereau1
- 1 Registre des Hemopathies malignes de la Gironde, INSERM U1219 equipe EPICENE Bordeaux, France;
- 2 University Hospital of Caen, U1086 INSERM UCBN Cancers et preventions, France
- ↵* Corresponding author; email:
Due to addition of anti-CD20 to anthracycline-based chemotherapy, survival of diffuse large B-cell lymphoma increased during the last decade. Although these trends are encouraging, there are still persistent differences in survival within and between US and European countries suggesting the role of non-biological factors. Our aim was to investigate the influence of such factors on relative survival of diffuse large B-cell lymphoma patients. We conducted a retrospective multicenter registry-based study in France, between 2002 and 2008, on 1165 incident cases of diffuse large B-cell lymphoma Relative survival analyses were performed and data missing were controlled with 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 speciality of the care department (onco-hematology versus other), the travel time 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 clinical trial and treatment discussion in multidisciplinary meeting were strongly associated with a better survival outcome. In contrast, the socio-economic status (European Deprivation Index) was not associated with the outcome. Despite therapeutics advances, various non-biological factors affected the relative survival of diffuse large B-cell lymphoma patients. The notion of lymphoma-specific expertise seems to be essential to achieve optimal care management and reopen the debate of centralization of these patients care in hematology/oncology departments.
- Received July 19, 2016.
- Accepted November 24, 2016.
- Copyright © 2016, Ferrata Storti Foundation