Research Article

Effects of center type and socioeconomic factors on early mortality and overall survival of diffuse large B-cell lymphoma

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Department of Internal Medicine, Division of Oncology & Hematology, University of Nebraska Medical Center, Omaha, NE 68198, USA

Department of Internal Medicine, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA

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Baojiang Chen

Department of Biostatistics, University of Texas Health Science Center at Houston, College of Public Health in Austin, Austin, TX 78701, USA

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Smith Giri

Department of Internal Medicine, Division of Hematology & Oncology, Yale University, New Haven, CT 06510, USA

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Julie M Vose

Department of Internal Medicine, Division of Oncology & Hematology, University of Nebraska Medical Center, Omaha, NE 68198, USA

Department of Internal Medicine, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA

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James O Armitage

Department of Internal Medicine, Division of Oncology & Hematology, University of Nebraska Medical Center, Omaha, NE 68198, USA

Department of Internal Medicine, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA

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Vijaya Raj Bhatt

Department of Internal Medicine, Division of Oncology & Hematology, University of Nebraska Medical Center, Omaha, NE 68198, USA

Department of Internal Medicine, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA

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Published Online:30 May 2019https://doi.org/10.2217/fon-2018-0596

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Abstract

Aim: To examine whether the center type and socioeconomic factors significantly impact 1-month mortality and overall survival (OS) of patients with diffuse large B-cell lymphoma (DLBCL). Methods: National Cancer Database (NCDB) was used to identify patients diagnosed with diffuse large B-cell lymphoma from 2006 to 2012 (postrituximab era). Results: Among 185,183 patients, 33% were treated at academic centers. The receipt of therapy at larger volume centers was associated with improved 1-month mortality. Academic centers had better OS than nonacademic centers in univariable analysis. Younger age, private insurance, lower Charlson comorbidity score and lower lymphoma stage were associated with improved 1-month mortality and OS. Conclusion: The receipt of therapy at larger volume centers and socioeconomic factors were associated with improved survival.

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Vol. 15, No. 18

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History

Received 5 August 2018

Accepted 18 March 2019

Published online 30 May 2019

Published in print June 2019

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2018-0596

Acknowledgments

The National Cancer Database is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The data used in the study are derived from a de-identified National Cancer Database file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology used or the conclusions drawn from these data by the investigators. The authors would also like to thank A Kallam and N Khanal for their contribution.

Financial & competing interests disclosure

VR Bhatt reports serving as a consultant for Pfizer and CSL Behring. JO Armitage reports serving as a consultant for Conatus- IDMC, Samus Therapeutics and Ascentage, and is on the board of directors for Tesaro bio, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

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