title: Reasons for lower survival from non-Hodgkin's lymphoma among older patients.
abstract: Cancer-registry data for 710 patients, treated for non-Hodgkin's lymphoma (NHL) at a South Australian teaching hospital between 1977 and 2000, gave a five-year disease-specific survival of 53%, which was similar to population based estimates for Australia, the USA, and Europe. This figure reduced with age at diagnosis from 69% for patients less than 40 years at diagnosis to 30% for those aged 80 years or more. Multivariable analysis indicated that older age was predictive of lower survival (p<0.001), after adjusting for grade (Working Formulation), Ann Arbor stage,bulk disease, B symptoms (weight loss, unexplained fever, night sweats), extra-lymphatic site involvement, and diagnostic period. No other clinical variable, when included in the model, affected the risk coefficient for age. Even among patients gaining complete remission following chemotherapy, the relative risk of death from NHL was 2.11(95% CL: 1.24, 3.57) for patients aged 70 years or more at diagnosis when compared with younger patients. We conclude that older patients have lower survivals not explained by established risk factors and that this also applies to patients who achieve complete remission following chemotherapy.
authors.affiliation: Department of Haematology-Oncology Queen Elizabeth Hospital, Adelaide.
authors.forename: Peter
authors.initials: P
authors.lastname: Bardy
authors.forename: Edward
authors.initials: E
authors.lastname: Sage
authors.forename: John
authors.initials: J
authors.lastname: Norman
authors.forename: Sanjev
authors.initials: S
authors.lastname: Chunilal
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Dart
authors.forename: Ken
authors.initials: K
authors.lastname: Pittman
authors.forename: Keven
authors.initials: K
authors.lastname: Patterson
authors.forename: Timothy
authors.initials: T
authors.lastname: Price
authors.forename: Margaret
authors.initials: M
authors.lastname: Colbeck
authors.forename: Lesley
authors.initials: L
authors.lastname: Milliken
authors.forename: Colin
authors.initials: C
authors.lastname: Luke
authors.forename: David
authors.initials: D
authors.lastname: Roder
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005060:Europe; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014481:United States