{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:27:09Z","timestamp":1789608429903,"version":"build-2803163510"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K24CA208132"],"award-info":[{"award-number":["K24CA208132"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite effective therapies, outcomes for diffuse large B\u2010cell lymphoma (DLCBL) remain heterogeneous in older individuals due to comorbid diseases and variations in disease biology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare database, the authors conducted a multistate survival analysis of 11,780 patients with DLBCL who were aged \u226565\u00a0years at the time of diagnosis (2002\u20102009). Cox proportional hazards models were used to specify the impact of prognostic factors on overall survival and cause\u2010specific deaths, and the Aalen\u2010Johansen estimator was used to project the course of DLBCL over time with or without standard therapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R\u2010CHOP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Advanced age (hazard ratio [HR] for ages 71\u201075\u00a0years: 1.25; HR for ages 76\u201080\u00a0years: 1.46; HR for ages 81\u201085\u00a0years: 1.88; and HR for age \u226586\u00a0years: 2.26), DLBCL stage (HR for Ann Arbor stage II: 1.28; HR for stage III: 1.54; and HR for stage IV: 1.95), Charlson Comorbidity Index (CCI) \u22651 (HR for CCI of 1, 1.15; and HR for CCI &gt;1, 1.37), and not being married (HR, 1.12) were associated with an increased risk of DLBCL\u2010specific death. Being female (HR, 0.91) and of higher socioeconomic status (HR, 0.91) were associated with a lower risk of DLBCL\u2010related mortality after therapy. For patients treated with R\u2010CHOP (3610 patients), the risk of death due to DLBCL was 14.0% and 18.6%, respectively, at 2 and 5\u00a0years of treatment and plateaued afterward, confirming a 5\u2010year \u201ccure\u201d point while receiving R\u2010CHOP among older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Conducting a survival analysis over a large data set, the current study evaluated competing risks for death within a multistate modeling framework, and identified age, sex, and CCI as risk factors for DLBCL\u2010specific and other causes of death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31981","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T16:31:37Z","timestamp":1549038697000},"page":"1837-1847","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A population\u2010based multistate model for diffuse large B\u2010cell lymphoma\u2013specific mortality in older patients"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9991-8457","authenticated-orcid":false,"given":"\u00c7a\u011flar","family":"\u00c7a\u011flayan","sequence":"first","affiliation":[{"name":"H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan S.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turgay","family":"Ayer","sequence":"additional","affiliation":[{"name":"H. 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