Long-term follow up of Hodgkin lymphoma
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David Perez-Callejo1,*, Lorea Zurutuza1,*, Ana Royuela2, Maria Torrente1, Beatriz Núñez1, Virginia Calvo1, Miriam Méndez1, Fernando Franco1, María Auxiliadora Brenes1, Juan Cristobal Sánchez1 and Mariano Provencio1
1Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
2Statistics Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
*These authors contributed equally to this work
Mariano Provencio, email: [email protected]
Keywords: Hodgkin lymphoma; survival; standardized mortality ratio
Received: September 27, 2017 Accepted: January 13, 2018 Published: February 03, 2018
Background: Hodgkin lymphoma (HL) is the paradigm of curable disease. This study analyzed the overall survival (OS) of patients with HL and compared their survival between decades and with the expected survival of a general population.
Results: The median follow-up was 22 years. The median OS was 33 years. The incidence mortality rate for all causes is 2 per every 100 patients per year. The OS of our cohort at 10 years from diagnosis was 76% (95% CI: 72–79) and 52% at 30 years (95% CI: 48–57). Overall SMR (1980–2013) was 2,943 (95% CI: 2,518–3,439). Excluding the primary tumor as the cause of death, the SMR obtained is 2,266 (95% CI: 1,895–2,710). The SMR for those patients diagnosed before the year 2000 was 2,097 (95% CI: 1,732–2,539); and for those diagnosed after 2000 was 5,218 (95% CI: 8,655). The group of patients diagnosed after 2000 had statistically significant more advanced stages, were older and less responsive to treatment.
Conclusions: Despite the advances achieved, the risk of death remains higher than in the general population, mainly for those patients diagnosed after year 2000, even after almost 40 years of follow-up. This data might suggest a shift to more aggressive forms of disease in recent years.
Patients and methods: A total of 595 patients diagnosed with HL were included between January 1966 and February 2014. The standardized mortality ratio (SMR) was analyzed using the annual rate of mortality in the general Spanish population, adjusted for age, sex and time period.
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