Comparison of the long-term mortality in Hodgkin's disease patients with that of the general population.
BACKGROUND
Although Hodgkin's disease can be treated successfully, its long-term survival rate has yet to be definitely established. We compared the long-term mortality rate of patients diagnosed as having Hodgkin's disease with that of the general population.


METHODS
We studied a retrospective cohort of 477 patients who received pathology-confirmed diagnoses of Hodgkin's disease between 1967 and 1993 and were treated with combined chemotherapy or radiotherapy with follow-up from the day of diagnosis. Standardised mortality ratios were computed with reference rates taken from the Spanish population.


RESULTS
The follow-up was complete for 427 (89.5%) of the patients. The median follow-up time was 8 years, 133 patients (28%) died and the median survival time was 21 years. The overall survival rates were 80% at 5 years, 70% at 10 years, and 64% at 15 years after diagnosis. The standardised mortality ratios were 10.8 (95% confidence interval: 9.0-12.8, P < 0.0001) overall, 5.5 in patients in favourable stages (IA, IIA), and 15.2 in those with unfavourable stages (IB, IIB, III, IV). There was a decreasing trend in mortality by calendar period (standardised mortality ratios for 1967-1975, 1976-1974 and 1985-1993: 16.8, 10.3 and 5.1, respectively). Higher mortality was observed in all periods of follow-up after diagnosis, even after 20 years.


CONCLUSIONS
Despite the improvements in treatment, mortality in Hodgkin's disease remains higher than in the general population in all disease stages, even 20 years after diagnosis.
Provencio
M
M
Department of Oncology, Hospital Universitario Clínica Puerta de Hierro, Madrid, Spain. marianop@ene.es
García-López
F J
FJ
Bonilla
F
F
España
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate