Department of Medicine, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma, OK.
Department of Medicine, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma, OK; Stephenson Cancer Center Biostatistics Research and Design Core, Oklahoma, OK.
Clin Lymphoma Myeloma Leuk. 2023 May;23(5):379-384. doi: 10.1016/j.clml.2023.01.015. Epub 2023 Feb 1.
Advances in treatment for patients with Diffuse Large B-Cell Lymphoma (DLBCL) have led to improved patient outcomes but the magnitude of these disparities remains understudied with regards to improved survival outcomes. We sought to describe changes in DLBCL survival trends over time and explore potential differential survival patterns by patients' race/ethnicity and age.
We utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with DLBCL from 1980 to 009 and determined 5-year survival outcomes for all patients, categorizing patients by year of diagnosis. We used descriptive statistics and logistic regression, adjusting for stage and year of diagnosis, to describe changes in 5-year survival rates over time by race/ethnicity and age.
We identified 43,564 patients with DLBCL eligible for this study. Median age was 67 years (ages: 18-64 = 44.2%, 65-79 = 37.1%, 80 + = 18.7%). Most patients were male (53.4%) and had advanced stage III/IV disease (40.0%). Most patients were White race (81.4%), followed by Asian/Pacific Islander (API) (6.3%), Black (6.3%), Hispanic (5.4%), and American Indian/Alaska Native (AIAN) (0.05%). Overall, the 5-year survival rate improved from 35.1% in 1980 to 52.4% in 2009 across all races and age groups (odds ratio [OR] for 5-year survival with increasing year of diagnosis = 1.05, P < .001). Patients in racial/ethnic minority groups (API: OR = 0.86, P < .0001; Black: OR = 0.57, P < .0001; AIAN: OR = 0.51, P = .008; Hispanic: 0.76, P = 0.291) and older adults (ages 65-79: OR = 0.43, P < .0001; ages 80+: OR = 0.13, P < .0001) had lower 5-year survival rates after adjusting for race, age, stage, and diagnosis year. We found consistent improvement in the odds of 5-year survival for year of diagnosis across all race and ethnicity groups (White: OR = 1.05, P < .001; API: OR = 1.04, P < .001; Black: OR = 1.06, p<.001; AIAN: OR = 1.05, P < .001; Hispanic: OR = 1.05, P < .005) and age groups (ages 18-64: OR = 1.06, P < .001; ages 65-79: OR = 1.04, P < .001; ages 80+: OR = 1.04, P < .001).
Patients with DLBCL experienced improvements in 5-year survival rates from 1980 to 2009, despite persistently lower survival among patients in racial/ethnic minority groups and older adults.
弥漫性大 B 细胞淋巴瘤（DLBCL）患者的治疗进展导致患者预后改善，但在生存结果改善方面，种族/民族和年龄对生存差异的影响仍研究不足。我们旨在描述随着时间的推移 DLBCL 生存趋势的变化，并探讨患者种族/民族和年龄的潜在差异生存模式。
我们利用监测、流行病学和最终结果（SEER）数据库，从 1980 年到 2009 年确定了诊断为 DLBCL 的患者，并确定了所有患者的 5 年生存结果，按诊断年份对患者进行分类。我们使用描述性统计和逻辑回归，调整分期和诊断年份，描述不同种族/民族和年龄组的 5 年生存率随时间的变化。
我们确定了 43564 名符合本研究条件的 DLBCL 患者。中位年龄为 67 岁（年龄：18-64 岁=44.2%，65-79 岁=37.1%，80 岁及以上=18.7%）。大多数患者为男性（53.4%），处于晚期 III/IV 期（40.0%）。大多数患者为白人种族（81.4%），其次是亚太裔（6.3%）、黑人（6.3%）、西班牙裔（5.4%）和美洲印第安人/阿拉斯加原住民（0.05%）。总体而言，所有种族和年龄组的 5 年生存率从 1980 年的 35.1%提高到 2009 年的 52.4%（诊断年份每增加一年的 5 年生存率比值比[OR]为 1.05，P<.001）。少数民族群体（亚太裔：OR=0.86，P<.0001；黑人：OR=0.57，P<.0001；美洲印第安人/阿拉斯加原住民：OR=0.51，P=.008；西班牙裔：0.76，P=.291）和老年人（65-79 岁：OR=0.43，P<.0001；80 岁及以上：OR=0.13，P<.0001）的 5 年生存率较低，调整种族、年龄、分期和诊断年份后。我们发现，所有种族和民族群体（白人：OR=1.05，P<.001；亚太裔：OR=1.04，P<.001；黑人：OR=1.06，P<.001；美洲印第安人/阿拉斯加原住民：OR=1.05，P<.001；西班牙裔：OR=1.05，P<.005）和年龄组（18-64 岁：OR=1.06，P<.001；65-79 岁：OR=1.04，P<.001；80 岁及以上：OR=1.04，P<.001）的诊断年份每增加一年，5 年生存率的优势均有所提高。
尽管少数民族群体和老年人的生存持续较低，但从 1980 年到 2009 年，DLBCL 患者的 5 年生存率仍有所改善。
