Early and late survival in Hodgkin disease among whites and blacks living in the United States.
BACKGROUND
The independent effect of race on response to treatment and prognosis in Hodgkin disease is unclear.


METHODS
The study included 9482 patients with histologically confirmed Hodgkin disease reported by 1084 different hospitals and institutions in the United States. The independent effect of race on response to treatment and recurrence was estimated using the logistic model. Cox proportional hazard model was applied to determine the independent effect of race and other covariables on risk of death.


RESULTS
Complete remission occurred in more white patients (67.3%) than black patients (58.2%). Recurrences were reported more often in black patients than in white patients (40.3% and 30.9% respectively). Controlling for confounding variables, race has a significant independent effect on remission and recurrence (P < 0.05). In the first 5 years after diagnosis of Hodgkin disease, the patient age at diagnosis, clinical stage, and histologic type were significant predictors for the risk of death. At 5-10 years after a diagnosis of Hodgkin disease, age, clinical stage, and race of the patient were found to be significant risk factors (whites versus blacks: RR = 0.56; P < 0.05).


CONCLUSIONS
Race is a significant predictor for remission, recurrence and survival in Hodgkin disease. Black patients have a more unfavorable prognosis than do white patients.
Zaki
A
A
Department of Medical Statistics, Medical Research Institute, Alexandria, Egypt.
Natarajan
N
N
Mettlin
C J
CJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality* / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012306:Risk; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States; D044465:White People