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Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
Long-term survival after treatment for Hodgkin's disease (1973-2002): improved survival with successive 10-year
E M Bessell1, G Bouliotis, S Armstrong
1Department of Clinical Oncology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. ebessell@hotmail.co.uk
Insights
Survival rates for Hodgkin's lymphoma have significantly improved over three decades due to treatment advances. This study analyzed 745 patients, showing increased 15-year survival from 57% to 83% between 1973 and 2002.
Area of Science:
- Oncology
- Epidemiology
- Biostatistics
Background:
- The Nottinghamshire Lymphoma Registry tracked lymphoma patients from 1973.
- A defined population of 1.1 million allowed for cohort analysis of Hodgkin's disease treatment outcomes.
- Three 10-year cohorts (1973-1982, 1983-1992, 1993-2002) were studied.
Purpose of the Study:
- To compare survival times across three distinct patient cohorts.
- To identify prognostic factors influencing Hodgkin's disease outcomes.
- To estimate relative survival rates over time.
Main Methods:
- Analysis of survival data for 745 patients diagnosed between 1973 and 2002.
- Kaplan-Meier method and parametric survival models used for survivorship estimation.
- Accelerated failure-time regression applied for multivariate analysis.
Main Results:
- Overall 1-, 5-, and 15-year disease-specific survival rates were 87%, 77%, and 70%, respectively.
- Significant increase in 15-year survival: 57% (1973-1982) to 83% (1993-2002) (P<0.001).
- The 20-year actuarial risk of a second malignancy was 12.4% for the earliest cohort and 18.8% for the second.
Conclusions:
- Treatment advancements have led to significantly longer survival for Hodgkin's disease patients.
- Effective management of treatment toxicities has contributed to improved patient outcomes.
- Long-term survival rates demonstrate a positive trend in Hodgkin's disease management over three decades.
Background:
The Nottinghamshire Lymphoma Registry contains the details of all the patients diagnosed with lymphoma (since 1 January 1973) within a defined geographical area with a population of 1.1 million. It was therefore possible to study the outcome of treatment for Hodgkin's disease for three 10-year cohorts (1973-1982, 1983-1992 and 1993-2002).The aims of the study were to compare survival time among the three patient cohorts, to identify prognostic factors and to estimate relative survival.
Methods:
A total of 745 patients diagnosed between 1973 and 2002 were analysed for survival. Survivorship was estimated by the Kaplan-Meier method and parametric survival models. An accelerated failure-time regression was used for multivariate analysis.
Results:
Overall, patients were observed for 9.8 (0.3-34.82) years (median(range)), on average. One, five and fifteen-year disease-specific survival was found to be 87% (85-90%), 77% (74-80%) and 70% (67-74%), respectively. For those for diagnosed between 1973 and 1982, the 15-year survival was found to be 57%; for 1983-1992, it was 74% and for 1993-2002, it was 83% (P<0.001). The difference remained significant after adjusting for prognostic factors. The actuarial risk of developing a second malignancy at 20 years was for the 1973-1982 cohort, 12.4%, and for the 1983-1992 cohort, 18.8%.
Conclusion:
Treatment advances and effective management of toxicities of treatment over time, have resulted in a significantly longer survival for patients with Hodgkin's disease diagnosed within a defined population.
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