title: Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study.
abstract: BACKGROUND
  The increased risk of gastrointestinal (GI) cancers after Hodgkin's lymphoma (HL) is well established. However, no large population-based study has described the actuarial survival after subsequent GI cancers in HL survivors (HL-GI).
  
  
  METHODS
  For 209 patients with HL-GI cancers (105 colon, 35 stomach, 30 pancreas, 21 rectum, and 18 esophagus) and 484 165 patients with first primary GI cancers (GI-1), actuarial survival was compared, accounting for age, gender, race, GI cancer stage, radiation for HL, and other variables.
  
  
  RESULTS
  Though survival of HL patients who developed localized stage colon cancer was similar to that of the GI-1 group, overall survival (OS) of HL patients with regional or distant stage colon cancer was reduced [hazard ratio, (HR)=1.46, P=0.01]. The HL survivors with regional or distant stage colon cancer in the transverse segment had an especially high risk of mortality (HR: 2.7, P=0.001 for OS). For localized stomach cancer, OS was inferior among HL survivors (HR=3.46, P=0.006).
  
  
  CONCLUSIONS
  The HL patients who develop GI cancer experience significantly reduced survival compared with patients with a first primary GI cancer. Further research is needed to explain the inferior survival of HL patients and to define selection criteria for cancer screening in HL survivors.
authors.affiliation: Department of Radiation Oncology and Rubin Center for Cancer Survivorship, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: P
authors.initials: P
authors.lastname: Youn
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: M T
authors.initials: MT
authors.lastname: Milano
authors.forename: M
authors.initials: M
authors.lastname: Stovall
authors.forename: L S
authors.initials: LS
authors.lastname: Constine
authors.forename: L B
authors.initials: LB
authors.lastname: Travis
mesh_terms: D000368:Aged; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000503:physiopathology* / Q000532:radiotherapy; D006689:Hodgkin Disease / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D018426:SEER Program; D016019:Survival Analysis