Single-Center Study Finds Lymphoma Survival Rates Improved Over Time

Patients who are diagnosed with lymphoma today have significantly better odds than patients diagnosed 20 years ago, according to a new analysis.

The study, published in the journal Cancer Medicine, sought to track outcomes over time and help investigators better understand the factors that affect survival rates in various types of lymphomas.

Overall, 3760 patients were included in the study. All were diagnosed with lymphoma between 1996 and 2015, and all sought care at Beijing University Cancer Hospital and Institute, in China. In addition to being stratified by cancer type, the patients were also analyzed in 5-year cohorts to see whether overall survival changed with time.

At the end of the trial, the 5-year overall survival (OS) rate for the group as a whole was 62%, and the 10-year OS was 52%. Broken down temporally, patients who were diagnosed between 1996 and 2000 had a 48% 5-year OS, while patients diagnosed in the final 5 years of the study, 2011-2015, had a 5-year OS of 65%.

The authors say the broad improvement likely had to do with increases in the number of physicians and hospital beds per 1,000 people in China, as well as adjustments by the government that resulted in 95.7% of the country’s 1.37 billion people having insurance.

However, the authors also note that the success at their academic medical center likely was not replicated universally across the country. They say in order for other medical centers to see similar improvements, they would need to adopt similar guidelines and procedures.

“[T]he treatment of lymphoma in those tertiary hospitals like our academic center preferably complied with clinical practice guidelines and risk‐adapted individualizing strategy,” note corresponding author Jun Zhu, MD, PhD, and colleagues. “These findings strongly highlighted the need of standardized procedures of diagnosis and treatment, particularly for those nonacademic centers in China.”

The data also showed variances depending on the type of lymphoma with which the patient was diagnosed.

Patients with classic Hodgkin lymphoma (cHL) had a 5-year OS of 79%; those with mature B-cell lymphoma (BCL) had a 5-year OS of 63%; and patients with peripheral T-cell lymphoma (PTCL) had a 50% OS after 5 years.

Within mature BCL, those with follicular lymphoma had the highest 5-year OS (77.8%), and those with mantle cell lymphoma had the lowest (44.3%).

In PTCL, patients with ALK+anaplastic large cell lymphoma had a 5-year OS of 79.0%, but those with angioimmunoblastic T-cell lymphoma had just a 34.9% OS at 5 years.

Aside from center-specific or national factors, the investigators say broadly speaking, patients with each type of cancer have benefited with significant breakthroughs in terms of new chemotherapy and radiotherapy techniques. However, they say that among the category of lymphoma, PTCL remains the area with the highest need for new therapies. They write that their data also showed other health concerns need to be top of mind for physicians as they treat patients.

“In addition, secondary malignancies and cardiovascular diseases play an important role in death pattern, which allows insight into the balance between disease control and long‐term toxicity in the treatment decision‐making process for patients with lymphoma,” Zhu and colleagues conclude.

Reference

Liu W, Ji X, Song Y, et al. Improving survival of 3760 patients with lymphoma: Experience of an academic center over two decades. Cancer Med. 2020;00:1—10. doi.org/10.1002/cam4.3037