Mortality risk associated with treatment intensity level in fit, unfit, and frail patients, unadjusted and adjusted for IPI score, Ann Arbor stage, sex, and time period
| Variables . | Fit patients . | Unfit patients . | Frail patients . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2-y OS . | 2-y PFS . | 2-y OS . | 2-y PFS . | 2-y OS . | 2-y PFS . | |||||||
| HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | |
| Treatment, unadjusted | ||||||||||||
| R-CHOP > 80% | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| R-CHOP ≤ 80% | 2.37 (1.18-4.77) | .015 | 2.63 (1.39-4.97) | .003 | 1.23 (0.80-1.90) | .350 | 1.12 (0.73-1.70) | .608 | 1.11 (0.53-2.31) | .786 | 1.12 (0.54-2.33) | .761 |
| Anthracycline-free | 3.43 (1.03-11.4) | .045 | 5.59 (2.14-14.6) | <.001 | 2.47 (1.58-3.87) | <.001 | 2.55 (1.66-3.90) | <.001 | 1.88 (0.94-3.76) | .077 | 1.92 (0.96-3.86) | .066 |
| Anthracycline-free vs R-CHOP ≤ 80% | 1.44 (0.41-5.11) | .570 | 2.13 (0.77-5.86) | .145 | 2.01 (1.25-3.22) | .004 | 2.28 (1.44-3.61) | <.001 | 1.69 (1.12-2.55) | .012 | 1.72 (1.14-2.57) | .009 |
| Treatment, adjusted | ||||||||||||
| R-CHOP > 80% | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| R-CHOP ≤ 80% | 2.23 (1.06-4.69) | .034 | 2.31 (1.18-4.49) | .014 | 1.41 (0.90-2.21) | .137 | 1.29 (0.83-1.98) | .254 | 1.03 (0.48-2.21) | .946 | 1.08 (0.50-2.33) | .837 |
| Anthracycline-free | 6.10 (1.63-22.8) | .007 | 9.62 (3.24-28.5) | <.001 | 3.37 (2.10-5.40) | <.001 | 3.58 (2.28-5.58) | <.001 | 1.74 (0.84-3.59) | .134 | 1.81 (0.88-3.72) | .106 |
| Anthracycline-free vs R-CHOP ≤ 80% | 2.73 (0.70-10.6) | .147 | 4.17 (1.36-12.8) | .012 | 2.39 (1.46-3.91) | .001 | 2.77 (1.73-4.45) | <.001 | 1.69 (1.11-2.59) | .015 | 1.67 (1.10-2.55) | .017 |
| Variables . | Fit patients . | Unfit patients . | Frail patients . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2-y OS . | 2-y PFS . | 2-y OS . | 2-y PFS . | 2-y OS . | 2-y PFS . | |||||||
| HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | |
| Treatment, unadjusted | ||||||||||||
| R-CHOP > 80% | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| R-CHOP ≤ 80% | 2.37 (1.18-4.77) | .015 | 2.63 (1.39-4.97) | .003 | 1.23 (0.80-1.90) | .350 | 1.12 (0.73-1.70) | .608 | 1.11 (0.53-2.31) | .786 | 1.12 (0.54-2.33) | .761 |
| Anthracycline-free | 3.43 (1.03-11.4) | .045 | 5.59 (2.14-14.6) | <.001 | 2.47 (1.58-3.87) | <.001 | 2.55 (1.66-3.90) | <.001 | 1.88 (0.94-3.76) | .077 | 1.92 (0.96-3.86) | .066 |
| Anthracycline-free vs R-CHOP ≤ 80% | 1.44 (0.41-5.11) | .570 | 2.13 (0.77-5.86) | .145 | 2.01 (1.25-3.22) | .004 | 2.28 (1.44-3.61) | <.001 | 1.69 (1.12-2.55) | .012 | 1.72 (1.14-2.57) | .009 |
| Treatment, adjusted | ||||||||||||
| R-CHOP > 80% | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| R-CHOP ≤ 80% | 2.23 (1.06-4.69) | .034 | 2.31 (1.18-4.49) | .014 | 1.41 (0.90-2.21) | .137 | 1.29 (0.83-1.98) | .254 | 1.03 (0.48-2.21) | .946 | 1.08 (0.50-2.33) | .837 |
| Anthracycline-free | 6.10 (1.63-22.8) | .007 | 9.62 (3.24-28.5) | <.001 | 3.37 (2.10-5.40) | <.001 | 3.58 (2.28-5.58) | <.001 | 1.74 (0.84-3.59) | .134 | 1.81 (0.88-3.72) | .106 |
| Anthracycline-free vs R-CHOP ≤ 80% | 2.73 (0.70-10.6) | .147 | 4.17 (1.36-12.8) | .012 | 2.39 (1.46-3.91) | .001 | 2.77 (1.73-4.45) | <.001 | 1.69 (1.11-2.59) | .015 | 1.67 (1.10-2.55) | .017 |
Univariate and multivariate Cox regression model for 2-year OS and 2-year PFS. The P value is shown in bold when below a 5% significance threshold.
Analyses are performed on the total cohort and stratified for fit, unfit, and frail patients. Only patients who received chemotherapy are included in the analysis, and follow-up time is limited to 2 years. Missing values were imputed using MICE, with the exception of 1 patient in the unfit group with missing R-CHOP dosage. E-values for adjusted analysis fit patients, R-CHOP > 80% vs R-CHOP ≤ 80%: 2-year OS, E-value, 2.87; 2-year PFS, E-value, 2.95. E-value for adjusted analysis unfit patients, R-CHOP ≤ 80% vs anthracycline-free regimen: 2-year OS, E-value, 3.04; 2-year PFS, E-value, 3.43.
Adjusted for all IPI groups (1, 2, 3, and 4-5), all Ann Arbor stages (I, II, III, and IV), sex, and time period (2006-2011 vs 2012-2016), and ECOG PS (0, 1, 2, 3, and 4).