PMID- 29023692 OWN - NLM STAT- MEDLINE DCOM- 20180919 LR - 20180919 IS - 1097-0215 (Electronic) IS - 0020-7136 (Linking) VI - 142 IP - 5 DP - 2018 Mar 1 TI - Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients-An analysis from the Brazilian Hodgkin Lymphoma Registry. PG - 883-890 LID - 10.1002/ijc.31096 [doi] AB - Socioeconomic status (SES) is a well-known determinant of outcomes in cancer. The purpose of this study was to analyze the impact of the SES on the outcomes of Hodgkin lymphoma (HL) patients from the Brazilian Prospective HL Registry. SES stratification was done using an individual asset/education-based household index. A total of 624 classical HL patients with diagnosis from January/2009 to December/2014, and treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine), were analyzed. The median follow-up was 35.6 months, and 33% were classified as lower SES. The 3-year progression- free survival (PFS) in higher and lower SES were 78 and 64% (p < 0.0001), respectively. The 3-year overall survival (OS) in higher and lower SES were 94 and 82% (p < 0.0001), respectively. Lower SES patients were more likely to be >/= 60 years (16 vs. 8%, p = 0.003), and to present higher risk International Prognostic score (IPS) (44 vs. 31%, p = 0.004) and advanced disease (71 vs. 58%, p = 0.003). After adjustments for potential confounders, lower SES remained independently associated with poorer survival (HR = 3.12 [1.86-5.22] for OS and HR = 1.66 [1.19-2.32] for PFS). The fatality ratio during treatment was 7.5 and 1.3% for lower and higher SES (p = 0.0001). Infections and treatment toxicity accounted for 81% of these deaths. SES is an independent factor associated with shorter survival in HL in Brazil. Potential underlying mechanisms associated with the impact of SES are delayed diagnosis and poorer education. Educational and socio-economic support interventions must be tested in this vulnerable population. CI - (c) 2017 UICC. FAU - Biasoli, Irene AU - Biasoli I AUID- ORCID: 0000-0001-7265-7691 AD - School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Castro, Nelson AU - Castro N AD - Hospital de Cancer de Barretos, Barretos, Sao Paulo, Brazil. FAU - Delamain, Marcia AU - Delamain M AD - Hematology and Hemotherapy Center, University of Campinas, Campinas, Sao Paulo, Brazil. FAU - Silveira, Talita AU - Silveira T AD - Sao Paulo Santa Casa Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Farley, James AU - Farley J AD - Liga Norte Rio Grandense contra o cancer, Natal, Rio Grande do Norte, Brazil. FAU - Pinto Simoes, Belinda AU - Pinto Simoes B AD - USP-Ribeirao Preto, Ribeirao Preto, Sao Paulo, Brazil. FAU - Solza, Cristiana AU - Solza C AD - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Praxedes, Monica AU - Praxedes M AD - Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil. FAU - Baiocchi, Otavio AU - Baiocchi O AD - UNIFESP, Sao Paulo, Sao Paulo, Brazil. FAU - Gaiolla, Rafael AU - Gaiolla R AD - UNESP, Botucatu, Sao Paulo, Brazil. FAU - Franceschi, Fernanda AU - Franceschi F AD - Fundacao Amaral Carvalho-Jau, Jau, Sao Paulo, Brazil. FAU - Bonamin Sola, Caroline AU - Bonamin Sola C AD - Universidade Federal do Parana, Curitiba, Parana, Brazil. FAU - Boquimpani, Carla AU - Boquimpani C AD - HEMORIO, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Clementino, Nelma AU - Clementino N AD - Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. FAU - Fleury Perini, Guilherme AU - Fleury Perini G AD - Hospital Israelita Albert Einstein-SP, Sao Paulo, Sao Paulo, Brazil. FAU - Pagnano, Katia AU - Pagnano K AD - Hematology and Hemotherapy Center, University of Campinas, Campinas, Sao Paulo, Brazil. FAU - Steffenello, Giovana AU - Steffenello G AD - Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil. FAU - Tabacof, Jacques AU - Tabacof J AD - ESHO- Centro Paulistano de Oncologia, Sao Paulo, Sao Paulo, Brazil. FAU - de Freitas Colli, Gilberto AU - de Freitas Colli G AD - Hospital de Cancer de Barretos, Barretos, Sao Paulo, Brazil. FAU - Soares, Andrea AU - Soares A AD - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - de Souza, Carmino AU - de Souza C AD - Hematology and Hemotherapy Center, University of Campinas, Campinas, Sao Paulo, Brazil. FAU - Chiattone, Carlos Sergio AU - Chiattone CS AD - Sao Paulo Santa Casa Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Raggio Luiz, Ronir AU - Raggio Luiz R AD - Public Health Studies, UFRJ, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Milito, Cristiane AU - Milito C AD - School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Morais, Jose Carlos AU - Morais JC AD - School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Spector, Nelson AU - Spector N AD - School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20171026 PL - United States TA - Int J Cancer JT - International journal of cancer JID - 0042124 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use MH - Brazil MH - Female MH - Follow-Up Studies MH - Hodgkin Disease/drug therapy/*economics/*mortality MH - Humans MH - Income MH - Male MH - Middle Aged MH - Prognosis MH - Prospective Studies MH - Registries/*statistics & numerical data MH - *Social Class MH - Survival Rate MH - Young Adult EDAT- 2017/10/13 06:00 MHDA- 2018/09/20 06:00 CRDT- 2017/10/13 06:00 PHST- 2017/06/19 00:00 [received] PHST- 2017/09/29 00:00 [revised] PHST- 2017/10/02 00:00 [accepted] PHST- 2017/10/13 06:00 [pubmed] PHST- 2018/09/20 06:00 [medline] PHST- 2017/10/13 06:00 [entrez] AID - 10.1002/ijc.31096 [doi] PST - ppublish SO - Int J Cancer. 2018 Mar 1;142(5):883-890. doi: 10.1002/ijc.31096. Epub 2017 Oct 26.