Improved survival time trends in Hodgkin's lymphoma

Abstract

There have been dramatic changes in the staging and treatment of Hodgkin's lymphoma (HL) over the past 30 years. We undertook this study to determine if a stage migration had occurred and also examined if treatment associated with later years has improved survival. Patients with stage I‐IV HL between 1983 and 2011 were selected from the Surveillance, Epidemiology, and End Results database. Multivariable analysis (MVA) was performed using Cox proportional hazards modeling. The study cohort included 35,680 patients. The stage breakdown in 1983 according to A and B symptoms was follows: 18%, 21%, 12%, and 5% for stage IA, IIA, IIIA, and IVA disease, respectively, and 6%, 11%, 12%, and 15% for stage IB, IIB, IIIB, and IVB disease. The stage breakdown in 2011 according to A and B symptoms was follows: 9%, 29%, 10%, and 6% for stage IA, IIA, IIIA, and IVA disease, respectively, and 4%, 16%, 12%, and 13% for stage IB, IIB, IIIB, and IVB disease. The median follow‐up for the entire cohort is 6.1 years. On MVA, the HR for mortality of patients diagnosed in 2006 was 0.60 (95% Confidence Interval (CI): 0.52–0.70) compared to 1983. For stage I and II patients diagnosed in 2006 the HR was 0.62 (95% CI: 0.44–0.87) and 0.40 (95% CI: 0.30–0.55), respectively, compared to patients diagnosed in 1983. For stage III and IV patients diagnosed in 2006 the HR was 0.72 (95% CI: 0.53–0.98) and 0.74 (95% CI: 0.56–0.99), respectively, compared to patients diagnosed in 1983. This is the first study to demonstrate a significant stage migration in early stage Hodgkin's lymphoma. Furthermore, these results demonstrate an improvement in survival over time for patients with Hodgkin's lymphoma which was particularly notable for those with early stage disease.

Long-Term Survival Rates of Patients with Stage III–IV Hodgkin Lymphoma According to Age, Sex, Race, and Socioeconomic Status, 1984–2013

“…This study demonstrated improvement of survival rates in aHL patients over time . It also updates incidence and survival information for aHL cases.…”

More frequent use of health care services among distressed compared with nondistressed survivors of lymphoma and chronic lymphocytic leukemia: Results from the population‐based PROFILES registry

“…Due to advances in the treatment of lymphoma and chronic lymphocytic leukemia (CLL), a rising incidence, and aging of the population, the number of patients who are living with a history of lymphoma or CLL continues to grow . It is expected that in 2020 there will be approximately 40,000 patients in the Netherlands who either are cured of their lymphoma or are living with it as a chronic disease, an increase of approximately 65% compared with 2010.…”

Treatment for lymphoma and late cardiovascular disease risk: A systematic review and meta‐analysis

“…Another limitation of this study was that we did not restrict to studies only looking at contemporary treatments, and there have been changes in treatments over time. Therefore, it is possible that the large effects found in our analyses may be overestimating the effects that truly occur in current practice with improved treatment modalities …”