Long-Term Survival Rates of Patients with Stage III–IV Hodgkin Lymphoma According to Age, Sex, Race, and Socioeconomic Status, 1984–2013

Li, Yushi; Sun, Han; Yan, Yan; Sun, Tiantian; Wang, Shuncong; Ma, Hu

doi:10.1634/theoncologist.2017-0541

Cited by 13 publications

(10 citation statements)

References 31 publications

(31 reference statements)

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“…A study by Shenoy et al also demonstrated an improvement in the survival of HL over time but included both early‐ and advanced‐stage HL as well as nodular lymphocyte predominant HL . Another study by Li et al, focusing on patients with advanced‐stage HL from the SEER database, demonstrated improving survival from 1983 to 2013 . However, there are key differences between this study and our study.…”

Section: Discussioncontrasting

confidence: 55%

Contemporary Outcomes for Advanced-Stage Classical Hodgkin Lymphoma in the U.S.: Analysis of Surveillance, Epidemiology, and End Results Database

et al. 2019

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Background Advanced‐stage Hodgkin lymphoma (HL) is a curable malignancy, although outcomes remain poor in certain patients. It remains unclear if recent advances have improved their population‐level survival over time. Materials and Methods Using the Surveillance, Epidemiology, and End Results database, we identified patients aged ≥18 years with stage III or IV classical HL as the first primary malignancy, diagnosed between 2000 and 2014 and treated with chemotherapy. Patients were stratified by date of diagnosis into three groups (2000–2004, 2005–2009, 2010–2014) to assess the trends in overall survival (OS). Results A total of 9,042 patients with a median age of 41 years were included. The use of frontline radiation therapy decreased in each period (21.3% [2000–2004] vs. 15.5% [2005–2009] vs. 10.7% [2010–2014]; p < .001). Three‐year OS was significantly higher for patients diagnosed between 2010 and 2014 (81.8%) and 2005 and 2009 (80.6%) compared with 2000 and 2004 (78.5%; p = .0008 and .02, respectively). Whereas outcomes were poorest in the age >60 cohort, similar improvements were also seen in 3‐year OS over the three time periods within this patient population. On multivariate analysis, diagnosis in the earlier period and minority race were associated with higher mortality. Females and married patients had significantly lower mortality risk. Conclusion Survival of patients with advanced‐stage HL has continued to improve over time, suggesting the impact of evolving treatment approaches. Three‐year OS in the contemporary period remains inadequate at 81.8%, highlighting the need for continued research to improve their outcomes. Implications for Practice This article evaluates contemporary outcomes for advanced‐stage Hodgkin lymphoma (HL) in the U.S. using the Surveillance, Epidemiology, and End Results database. Although overall survival (OS) has improved in each 5‐year period since 2000, the 3‐year OS from 2010 to 2014 remains inadequate at 81.8% and is limited by patient demographics. New therapies are indicated to improve clinical outcomes in advanced‐stage HL.

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Section: Discussioncontrasting

confidence: 55%

Contemporary Outcomes for Advanced-Stage Classical Hodgkin Lymphoma in the U.S.: Analysis of Surveillance, Epidemiology, and End Results Database

et al. 2019

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“…We only adjusted the excess mortality estimates for age and year of diagnosis, but cancer survival is affected by multiple, interacting factors such as disease stage, tumor characteristics, treatment and ability to tolerate and comply to treatment, comorbidity burden, performance status, socioeconomic status, and more. In studies including detailed prognostic factors, male sex has remained a significant negative prognostic factor in several lymphoma subtypes 13,14,16,17,32–41 . In a large UK study that explored the effect of comorbidity and socioeconomic factors on DLBCL and FL survival, male sex was an independent, negative prognostic factor in both subtypes despite meticulous adjustments 32 .…”

Section: Discussionmentioning

confidence: 99%

“…We found a significant survival disadvantage in men compared to women with cHL. Male sex is included in the IPS 11 and has remained a consistent negative prognostic factor in recent studies, 9,12,13 although some studies have suggested a weakened association over time 38,45,46 . Interestingly, cHL subclass distribution differs between men and women, 12 suggesting sex‐related differences in pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in lymphoma incidence and mortality by subtype: A population‐based study

et al. 2022

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It is well established that the male sex is associated with increased risk for, as well as poorer survival of, most cancers. A similar pattern has been described in lymphomas but has not yet been comprehensively assessed. In this nationwide population‐based cohort study, we used the Swedish Lymphoma Register to investigate sex differences in lymphoma subtype incidence and excess mortality in adults (age 18–99) diagnosed in 2000–2019. Male‐to‐female incidence rate ratios (IRRs) and excess mortality ratios (EMRs) adjusted for age and calendar year were predicted using Poisson regression. We identified 36 795 lymphoma cases, 20 738 (56.4%) in men and 16 057 (43.6%) in women. Men were at significantly higher risk of 14 out of 16 lymphoma subtypes with IRRs ranging from 1.15 (95% confidence interval [CI] 1.09–1.22) in follicular lymphoma to 5.95 (95% CI 4.89–7.24) in hairy cell leukemia. EMRs >1 were seen in 13 out of 16 lymphoma subtypes indicating higher mortality in men, although only statistically significant for classical Hodgkin lymphoma 1.26 (95% CI 1.04–1.54), aggressive lymphoma not otherwise specified 1.29 (95% CI 1.08–1.55), and small lymphocytic lymphoma 1.52 (95% CI 1.11–2.07). A corresponding analysis using data from the Danish Lymphoma Register was performed with comparable results. In conclusion, we demonstrate a significantly higher incidence and trend toward higher mortality in men for most lymphoma subtypes. Future studies with large patient material that include detailed clinicopathological prognostic factors are warranted to further delineate and explain sex differences in lymphoma survival to enable optimal management of lymphoma patients regardless of sex.

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“… 32 , 33 , 34 , 35 Similarly, AYAs are likely to be under‐insured and this, in conjunction with socioeconomic status and geographic factors may contribute to their treatment locations, which in turn, likely impacts likelihood of CTT enrollment. 25 , 36 Further, health insurance status and socioeconomic status (SES) are both significantly associated with survival in AYAs with cancer, suggesting differences in the type and quality of care low‐income patients may be receiving across the U.S. 37 , 38 , 39 Numerous studies have shown that treatment at large academic centers is associated with improved survival rates for AYAs with cancer. One possible factor contributing to these findings related to location‐of‐care may be a difference in clinical trial enrollment rates across community and academic centers.…”

Section: Discussionmentioning

confidence: 99%

Patterns of National Cancer Institute‐Sponsored Clinical Trial Enrollment in Black Adolescents and Young Adults

et al. 2021

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Long-Term Survival Rates of Patients with Stage III–IV Hodgkin Lymphoma According to Age, Sex, Race, and Socioeconomic Status, 1984–2013

Cited by 13 publications

References 31 publications

Contemporary Outcomes for Advanced-Stage Classical Hodgkin Lymphoma in the U.S.: Analysis of Surveillance, Epidemiology, and End Results Database

Contemporary Outcomes for Advanced-Stage Classical Hodgkin Lymphoma in the U.S.: Analysis of Surveillance, Epidemiology, and End Results Database

Sex differences in lymphoma incidence and mortality by subtype: A population‐based study

Patterns of National Cancer Institute‐Sponsored Clinical Trial Enrollment in Black Adolescents and Young Adults

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