Five- and 10-year survival rates for patients with non-Hodgkin lymphoma appear to have increased from the 1990s to the early 21st century, according to a report in the March 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Non-Hodgkin lymphoma includes several cancers of the immune system that occur in approximately 20.4 of every 100,000 individuals, according to background information in the article. Treatment for the condition has evolved rapidly in recent years.
Dianne Pulte, M.D., of the German Cancer Research Center, Heidelberg, and colleagues analyzed data from the Surveillance, Epidemiology and End Results (SEER) Program of the U.S. National Cancer Institute. Survival rates were calculated based on two-year time periods between 1990 and 2004 within which patients were diagnosed with non-Hodgkin lymphoma, as well as by age group (15 to 44, 45 to 54, 55 to 64, 65 to 74 and 75 years or older), sex, race, tumor location (i.e. whether the disease was nodal [in the lymph nodes] or extranodal [in a site other than the lymph nodes]) and histologic subtype (to classify tumors as high-grade or low-grade).
Overall, five-year relative survival increased from 50.4 percent to 66.8 percent, and 10-year relative survival increased from 39.4 percent to 56.3 percent between 1990 to 1992 and 2002 to 2004, the authors write. Improvements were most pronounced in patients younger than 45 years (plus 26.8 and plus 27.1 percentage points for five- and 10-year survival, respectively), but improvements were seen in all age groups, in both sexes, in both nodal and extranodal disease and in both low-grade and high-grade disease. Improvements in prognosis were less in black patients than in white patients, especially in younger black patients.
Two factors may explain these improvements, the authors note. One is advances in therapy that have occurred between 1990 and 2004, particularly the introduction of antibody therapy for non-Hodgkin lymphoma, they write. Treatment with antibody therapy and chemotherapy has extended life expectancy in many cases, but whether and how often this extension represents a true cure is still unknown. In addition, improvements in the treatment of HIV have reduced the occurrence of HIV-related non-Hodgkin lymphomas and also made them easier to treat.
Our estimates of long-term survival in patients with non-Hodgkin lymphoma obtained by the period analysis method for the 2002 to 2004 period are much higher than previously available survival estimates, which mostly pertain to patients diagnosed in the 1990s, the authors conclude. Timely disclosure of the improvements in survival achieved in patients, clinicians, researchers and the public is essential.
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