Causes of death and effect of non-cancer-specific death on rates of overall survival in adult classic Hodgkin lymphoma: a populated-based competing risk analysis.
Causes of death and effect of non-cancer-specific death on rates of overall survival in adult classic Hodgkin lymphoma: a populated-based competing risk analysis.
复制标题
DOI：
10.1186/s12885-021-08683-x
复制
发表时间：
2021-08-25
期刊：
影响因子：
3.8
通讯作者：
Jia Y
中科院分区：
文献类型：
--
作者：
Gao J;Chen Y;Wu P;Wang F;Tao H;Shen Q;Wang S;Gong S;Zhang X;Zhou Z;Song X;Jia Y
经典型霍奇金淋巴瘤（cHL）的预后改善伴随着非癌症特异性死亡（non-CSD）的风险升高。本研究的目的是验证非CSD的发生率及其对成人cHL患者总生存率的影响。为了确保有足够的随访时间，我们分析了监测、流行病学和最终结果（SEER）数据库中1983年至2005年诊断的年龄≥20岁的cHL患者的回顾性数据。采用Logistic回归分析非CSD发生与各因素的关系。采用Fine-Gray方法计算了CSD和非CSD的累积发生率。应用累积发生率图和非CSD与所有死亡原因的比值来评估非CSD对总生存率的影响。最后，我们通过考克斯比例风险回归分析和竞争风险回归分析分析长期死亡率，以强调更适合cHL患者的生存模型。在纳入的18，518例患者中，有3768例CSD（20.3%）和3217例非CSD（17.4%）。二元Logistic回归分析显示，年龄大、病程早、男性、未婚、混合细胞型（MC）和淋巴细胞耗竭型（LD）、仅接受放疗（RT）的患者非CSD发生率高。在约280个月随访后，非CSD的累积发生率超过CSD。非CSD的最常见原因是心血管疾病、继发原发性肿瘤、感染性疾病、事故和自杀。在考克斯比例风险模型中，黑人、未婚、晚期或仅接受化疗（CT）的患者的死亡风险高于已婚、早期和接受联合治疗的白色患者;在竞争风险模型中，这些人群也被发现有更大的CSD风险，但非CSD的风险在不同种族和婚姻状况之间无显著差异，早期疾病患者和仅接受RT的患者发生非CSD的风险更高。淋巴瘤是大多数死亡患者的死因，但非CSD并不罕见。应密切监测cHL患者的心血管疾病和恶性肿瘤体征。非CSD降低了患者的总生存率，竞争风险模型比考克斯比例风险模型更适合于建立预后。在线版本包含补充材料，可通过10.1186/s12885-021-08683-x获得。
The improved prognosis of classic Hodgkin lymphoma (cHL) has been accompanied by elevated risks of non–cancer-specific death (non-CSD). The aim of this study was to verify the occurrence of non-CSD and its effect on rates of overall survival among adult patients with cHL. To ensure sufficient follow-up time, we analyzed retrospective data from patients aged ≥20 years with cHL that was diagnosed between 1983 and 2005 in the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was applied to analyze the non-CSD occurrence in relation to all factors. Using Fine-Gray’s method, we calculated the cumulative incidences of CSD and non-CSD. Stacked cumulative incidence plots and ratio of non-CSD to all causes of death were applied to evaluate the effect of non-CSD on rates of overall survival. Finally, we analyzed long-term mortality through Cox proportional hazard regression analysis and competing risk regression analysis to emphasize a more appropriate model of survival for patients with cHL. Among the 18,518 patients included, there were 3768 cases of CSD (20.3%) and 3217 of non-CSD (17.4%). Older age, earlier period, male sex, unmarried status, mixed cellularity (MC) and lymphocyte-depletion (LD) histological subtype, and patients received radiotherapy (RT) only were associated with more non-CSD according to binary logistic analysis. The cumulative incidence of non-CSD exceeded CSD after approximately 280 months follow-up. The most common causes of non-CSDs were cardiovascular disease, subsequent primary neoplasms, infectious diseases, accidents, and suicide. In a Cox proportional hazards model, patients who were black, unmarried, at an advanced stage or underwent chemotherapy (CT) alone were at greater risk of mortality than were white patients, who were married, at an early stage, and underwent combined modality; these populations were also found to be at greater risk for CSD in a competing risk model, but the risk of non-CSD did not differ significantly according to race and marital status, patients with early-stage disease and who underwent RT only were found to be at higher risk of non-CSD instead. Lymphoma was the cause of death in most patients who died, but non-CSD was not unusual. Patients with cHL should be monitored closely for signs of cardiovascular disease and malignant tumors. Rates of overall survival of patients were diminished by non-CSD, and a competing risk model was more suitable for establishing the prognosis than was the Cox proportional hazards model. The online version contains supplementary material available at 10.1186/s12885-021-08683-x.
登录
查看更多内容
影响因子：
45.3
作者：
Engert, A;Schiller, P;Diehl, V
通讯作者：
Diehl, V
影响因子：
28.4
作者：
Jhawar, Sachin R.;Rivera-Nunez, Zorimar;Parikh, Rahul R.
通讯作者：
Parikh, Rahul R.
影响因子：
2.6
作者：
Myrehaug, Sten;Pintilie, Melania;Hodgson, David C.
通讯作者：
Hodgson, David C.
DOI：
10.3322/caac.21438
发表时间：
2018-03
期刊：
CA: a cancer journal for clinicians
影响因子：
--
作者：
Shanbhag S;Ambinder RF
通讯作者：
Ambinder RF
影响因子：
4
作者：
Ebied A;Thanh Huan V;Makram OM;Sang TK;Ghorab M;Ngo HT;Iraqi A;Kamel MG;Dang TN;Vuong NL;Hirayama K;Huy NT
通讯作者：
Huy NT