Long-term survival after treatment for Hodgkin's disease (1973-2002): improved survival with successive 10-year cohorts.
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%.


CONCLUSIONS
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.
Department of Clinical Oncology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. ebessell@hotmail.co.uk
E M
EM
Bessell
G
G
Bouliotis
S
S
Armstrong
J
J
Baddeley
A P
AP
Haynes
S
S
O'Connor
H
H
Nicholls-Elliott
M
M
Bradley
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology