Evidence map›Paper›PMID 25675909›Full record

ArticleCancer2015

Disease characteristics, patterns of care, and survival in very elderly patients with diffuse large B-cell lymphoma.

Jessica N Williams, Ashish Rai, Joseph Lipscomb, Jean L Koff, Loretta J Nastoupil, Christopher R Flowers

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.

  1. Pooled it
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  12. Approaches to aggressive B-cell lymphomas in less fit patients.Hematology. American Society of Hematology. Education Program · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jessica N WilliamsEmory University School of Medicine, Atlanta, Georgia.
Ashish RaiDepartment of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Joseph LipscombDepartment of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Jean L KoffWinship Cancer Institute, Emory University, Atlanta, Georgia.
Loretta J NastoupilDivision of Cancer Medicine, Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Christopher R FlowersWinship Cancer Institute, Emory University, Atlanta, Georgia.
Emory University · USThe University of Texas MD Anderson Cancer Center · US

Funding

Biological Variants Underlying Racial Differences in LymphomaR21CA158686 · NCI · EMORY UNIVERSITY · PI FLOWERS, CHRISTOPHER R · 2012 to 2013
$371k
NCI NIH HHS R21 CA158686
6 · The paper itself

Abstract

backgroundAlthough the combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is considered standard therapy for diffuse large B-cell lymphoma (DLBCL), patterns of use and the impact of R-CHOP on survival in patients aged >80 years are less clear.

methodsThe Surveillance, Epidemiology, and End Results (SEER)-Medicare database was used to characterize presentation, treatment, and survival patterns in patients with DLBCL who were diagnosed between 2002 and 2009. Chi-square tests compared characteristics and initial treatments among patients with DLBCL who were aged >80 years and ≤80 years. Multivariable logistic regression models examined factors associated with treatment selection in patients aged >80 years; standard and propensity score-adjusted multivariable Cox proportional hazards models examined relationships between treatment regimen, treatment duration, and survival.

resultsAmong 4635 patients with DLBCL, 1156 (25%) were aged >80 years. Patients aged >80 years were less likely to receive R-CHOP and more likely to be observed or receive the combination of rituximab, cyclophosphamide, vincristine, and prednisone (P<.0001 for both). Marital status, stage of disease, disease site, performance status, radiotherapy, and growth factor support were associated with initial R-CHOP in patients aged >80 years. In propensity score-matched multivariable Cox proportional hazards models examining relationships between treatment regimen and survival, R-CHOP was the only regimen found to be associated with improved overall survival (hazard ratio, 0.45; 95% confidence interval, 0.33-0.62) and lymphoma-related survival (hazard ratio, 0.58; 95% confidence interval, 0.38-0.88).

conclusionsAlthough patients with DLBCL who were aged >80 years were less likely to receive R-CHOP, this regimen conferred the longest survival and should be considered for this population. Further studies are needed to characterize the impact of treatment of DLBCL on quality of life among patients in this age group.

Indexed as

AgedAged, 80 and overAge FactorsAntibodies, Monoclonal, Murine-DerivedAntineoplastic Combined Chemotherapy ProtocolsCohort StudiesCyclophosphamideDoxorubicinFemaleHumansLymphoma, Large B-Cell, DiffuseMalePrednisoneRituximabSEER ProgramSurvival AnalysisAntibodies, Monoclonal, Murine-DerivedCyclophosphamideDoxorubicinPrednisoneR-CHOP protocolRituximabVincristine80 years and overageddiffusehematologic neoplasmslarge B-celllymphomatreatment outcome

Identifiers

PMID25675909
PMCPMC4441579
OpenAlexW1895923234

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.