The prognostic influence of socioeconomic status (SES) on the survival of diffuse large B-cell lymphoma (DLBCL) patients remains controversial. This observational study examines the potential impact of regional SES inequalities on overall survival (OS) among DLBCL patients in Germany. We analyzed data from the German nationwide population-based dataset spanning 2004-2019 sourced from the German Center for Cancer Registry Data (n = 49,465). The primary objective was to assess the 5-year OS among patients with low SES compared to those living in middle and high SES areas. SES was grouped according to quintiles of the German Index of Socioeconomic Deprivation, which summarized nine indicators covering aspects of regional education, employment, and income. DLBCL patients in low SES areas had significantly impaired 5-year OS compared to those in middle and high SES regions (59.2% vs. 61.8% vs. 64.1%, p < 0.0001). Yet, additionally accounting for regional premature mortality removed the impact of SES on survival (Hazard Ratio 0.94, 95% CI 0.87–1.01). Our findings indicate that the prognostic impact of socioeconomic deprivation on long-term survival is not due to variations in diagnosis and treatment of DLBCL itself but rather a higher comorbidity burden.
社会经济地位（SES）对弥漫大B细胞淋巴瘤（DLBCL）患者生存的预后影响仍存在争议。本观察性研究探讨了德国DLBCL患者中，地区性社会经济地位差异对总生存期（OS）的潜在影响。我们分析了来自德国癌症登记数据中心、覆盖2004-2019年的全国性人口数据集（n=49,465）。主要目的是比较低SES地区患者与中、高SES地区患者的5年OS。SES根据德国社会经济剥夺指数的五分位数进行分组，该指数综合了地区教育、就业和收入方面的九项指标。与中、高SES地区相比，低SES地区的DLBCL患者5年OS显著降低（59.2% vs. 61.8% vs. 64.1%，p<0.0001）。然而，在进一步纳入地区早逝率因素后，SES对生存的影响消失（风险比0.94，95% CI 0.87–1.01）。我们的研究结果表明，社会经济剥夺对长期生存的预后影响并非源于DLBCL诊断和治疗的差异，而是由更高的共病负担所致。
A German perspective on the impact of socioeconomic status in diffuse large B-cell lymphoma
肿瘤(癌症)患者之家