Comparison of Mortality Rates Between Patients With Diffuse Large B Cell Lymphoma Surviving 5 Years After Initial Diagnosis and a Matched General Population Cohort
John Acquavella, Dóra Körmendiné Farkas, Henrik Toft Sørensen
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引用次数: 0
Abstract
Aim
To determine whether mortality for patients with diffuse large B-cell lymphoma who survived 5 years (DLBCL5ys) returns thereafter to general population levels.
Methods
This population-based cohort study included Danish residents between January 1, 2000, and December 31, 2023. Information on diagnoses, comorbidities, and vital status came from Danish health and administrative registries. Analyses included 4164 DLBCL5yr patients—55% of incident patients—and 41,640 individuals from the general population matched 10:1 by exact birth year, sex, and the calendar year of achieving DLBCL5yr status. We used Cox proportional hazards models to compute matched mortality hazard ratios (HRs) and 95% confidence intervals (CIs) and controlled for comorbidities by adding Charlson comorbidity index scores to our models.
Results
Mortality rates were elevated for DLBCL5yr patients soon after their 5-year survival date. The absolute difference in mortality was 20 deaths per 1000 person-years, and the HR adjusted for comorbidities was 1.5 (95% CI 1.4–1.6). Mortality was elevated similarly for men and women. The elevated mortality for DLBCL5yr patients varied in magnitude by age, calendar period, and comorbidity burden, and included excess mortality from DLBCL, cancers other than lymphoma, and respiratory diseases.
Conclusions
We found that mortality for DLBCL5yr patients did not return to general population levels.
目的:确定存活5年的弥漫性大b细胞淋巴瘤(DLBCL5ys)患者的死亡率此后是否恢复到一般人群水平。方法:这项基于人群的队列研究纳入了2000年1月1日至2023年12月31日期间的丹麦居民。有关诊断、合并症和生命状况的信息来自丹麦卫生和行政登记处。分析包括4164名dlbcl5年患者(占事件患者的55%)和41640名来自普通人群的个体,按确切的出生年份、性别和达到dlbcl5年状态的日历年匹配10:1。我们使用Cox比例风险模型来计算匹配的死亡率风险比(hr)和95%置信区间(ci),并通过在模型中添加Charlson合并症指数得分来控制合并症。结果:dlbcl5年患者在其5年生存期后不久死亡率升高。死亡率的绝对差异为每1000人年20例死亡,经合并症调整后的HR为1.5 (95% CI 1.4-1.6)。男性和女性的死亡率上升幅度相似。dlbcl5年患者死亡率升高的幅度因年龄、日历期和合病负担而异,包括DLBCL、淋巴瘤以外的癌症和呼吸系统疾病的死亡率升高。结论:我们发现dlbcl5年患者的死亡率没有恢复到一般人群的水平。
期刊介绍:
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.