Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada.
Leuk Lymphoma. 2024 May;65(5):629-637. doi: 10.1080/10428194.2024.2306463. Epub 2024 Jan 24.
The aim of this study was to describe the impact of marginalization on DLBCL overall survival (OS) within the Canadian setting. We conducted a population-based retrospective cohort study of adult patients with newly diagnosed DLBCL in Ontario between 1 January 2005 and 31 December 2017 receiving a rituximab-containing chemotherapy regimen with curative intent followed until 1 March 2020. Our primary exposure of interest was the Ontario Marginalization Index (ON-Marg). The primary outcome was 2-year OS, accounting for patient age, sex, cancer characteristics, comorbidity burden, and rural dwelling status. While two-year overall survival was inferior for individuals in the most deprived marginalization quintile (70.4% Q5 vs. 76.0% Q1), after adjustment for relevant covariates neither the composite ON-Marg nor any of its dimensions had a significant effect. Within the Canadian context, among patients who receive chemotherapy, marginalization may not have a significant association with overall survival when accounting for key patient covariates, lending support for preserved outcomes.
本研究旨在描述在加拿大环境下边缘化对弥漫性大 B 细胞淋巴瘤（DLBCL）总生存（OS）的影响。我们进行了一项基于人群的回顾性队列研究，纳入了在 2005 年 1 月 1 日至 2017 年 12 月 31 日期间在安大略省被诊断为新发性、接受以治愈为目的含利妥昔单抗化疗方案治疗的 DLBCL 成年患者，并随访至 2020 年 3 月 1 日。我们主要关注的暴露因素是安大略省边缘化指数（ON-Marg）。主要结局是 2 年 OS，考虑了患者年龄、性别、癌症特征、合并症负担和农村居住状况。尽管最贫困边缘化五分位数（Q5）的个体 2 年总生存率较低（70.4% Q5 与 76.0% Q1），但在调整相关协变量后，综合 ON-Marg 及其任何维度均与总生存无显著关联。在加拿大的背景下，对于接受化疗的患者来说，在考虑到关键患者协变量的情况下，边缘化可能与总生存无显著关联，这支持了保留结果的观点。
