From the Journals

DLBCL patients at academic centers had significantly better survival



Academic centers had significantly improved overall survival of patients with diffuse large B-cell lymphoma (DLBCL), according to a large database study.

Researchers used the U.S. National Cancer Database to identify patients with a diagnosis of DLBCL from 2004 to 2015. The researchers identified 27,690 patients for the study. The majority of the patients were white (89.3%) and men (53.7%), with an average age of 64 years. A total of 57.6% of the patients had been treated at nonacademic centers and 42.4% at academic centers, and no notable differences were seen in facility choice among the low- to high-risk International Prognostic Index (IPI) risk categories.

The researchers found that overall survival of the DLBCL patients at academic centers was 108.3 months versus 74.5 months at nonacademic centers (P < .001), according to the study published in Clinical Lymphoma, Myeloma and Leukemia.

In addition, the median survival for patients with high-risk disease treated at academic centers was more than twice that of high-risk patients treated at nonacademic centers (33.5 months vs. 14.4 months, respectively; P < .001). Although the median survival for the other risk categories was also improved, the difference was less pronounced in the groups with lower IPI scores, according to the researchers.

Long-term overall survival for all patients with DLBCL at academic centers was significantly improved at both 5 and 10 years (59% and 43% survival, respectively) compared with those patients treated at nonacademic centers (51% and 35% survival, respectively; P < .001).

Speculating on factors that might be involved in this discrepancy in survival, the researchers suggested that academic centers might provide increased access to clinical trials, improved physician expertise, as well as improved treatment facilities and supportive care.

“Our results should prompt further investigation in precisely determining the factors that might support this significant effect on decreased survival among those treated in the community and help ameliorate this discrepancy,” the researchers concluded.

The authors reported that they had no conflicts of interest.

SOURCE: Ermann DA et al. Clin Lymphoma Myeloma Leuk. 2020;20(4): e17483.

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