Blood Cancer Journal ( IF 12.9 ) Pub Date : 2024-10-11 , DOI: 10.1038/s41408-024-01158-9 Susanne Ghandili, Judith Dierlamm, Carsten Bokemeyer, Henrik Kusche, Frederik Peters
The prognostic influence of socioeconomic status (SES) on the survival of diffuse large B-cell lymphoma (DLBCL) patients remains controversial. This observational study examines the potential impact of regional SES inequalities on overall survival (OS) among DLBCL patients in Germany. We analyzed data from the German nationwide population-based dataset spanning 2004-2019 sourced from the German Center for Cancer Registry Data (n = 49,465). The primary objective was to assess the 5-year OS among patients with low SES compared to those living in middle and high SES areas. SES was grouped according to quintiles of the German Index of Socioeconomic Deprivation, which summarized nine indicators covering aspects of regional education, employment, and income. DLBCL patients in low SES areas had significantly impaired 5-year OS compared to those in middle and high SES regions (59.2% vs. 61.8% vs. 64.1%, p < 0.0001). Yet, additionally accounting for regional premature mortality removed the impact of SES on survival (Hazard Ratio 0.94, 95% CI 0.87–1.01). Our findings indicate that the prognostic impact of socioeconomic deprivation on long-term survival is not due to variations in diagnosis and treatment of DLBCL itself but rather a higher comorbidity burden.
中文翻译:
德国人对弥漫性大 B 细胞淋巴瘤社会经济地位影响的看法
社会经济地位 (SES) 对弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者生存的预后影响仍然存在争议。这项观察性研究检查了区域 SES 不平等对德国 DLBCL 患者总生存期 (OS) 的潜在影响。我们分析了来自德国癌症登记中心 (n = 49,465) 的 2004-2019 年德国全国基于人群的数据集中的数据。主要目的是评估低 SES 患者与生活在中高 SES 地区的患者的 5 年 OS。SES 根据德国社会经济剥夺指数的五分位数进行分组,该指数总结了涵盖区域教育、就业和收入方面的九项指标。与中高 SES 区域的患者相比,低 SES 区域的 DLBCL 患者的 5 年 OS 显著受损 (59.2% vs. 61.8% vs. 64.1%,p < 0.0001)。然而,此外,考虑区域性过早死亡率消除了 SES 对生存率的影响 (风险比 0.94,95% CI 0.87-1.01)。我们的研究结果表明,社会经济剥夺对长期生存的预后影响不是由于 DLBCL 本身的诊断和治疗的不同,而是更高的合并症负担。