IMPROVED SURVIVAL OF HODGKINS PATIENTS IN SOUTH-EAST NETHERLANDS SINCE 1972

In the past 30 years, staging and treatment of Hodgkin's disease have changed dramatically, and prolonged remission can now be induced in th e majority of patients. Our purpose was to assess improvement in long- term survival, previously reported for specific patient groups, among unselected patients diagnosed and treated between 1972 and 1993 in gen eral hospitals in South-East Netherlands, Data on all 345 Hodgkin's pa tients were derived from the population-based Eindhoven Cancer Registr y; histopathology and clinical records were reviewed. Follow-up was at tained up to 1994. Relative survival rates, i.e. the ratio of observed to expected rates, were 80% after 5, 70% after 10 and 67% after 15 ye ars, Independent prognostic factors for lower overall survival were (i n decreasing order of significance): advanced age, histology (lymphocy te depletion), advanced stage and earlier period of diagnosis. Distrib ution of age and stage did not change over the study period, but there was a modest increase in the incidence of the nodular sclerosis histo logical subtype. Crude 5-year survival rates improved from 60% in the period 1972-1976 to 81% in the period of 1987-1992 (P < 0.005). The la rgest improvement occurred in the 1970s and was most prominent among t hose aged over 50 years. As previously reported, cured Hodgkin's patie nts exhibit a higher mortality rate, which can be explained by treatme nt-related long-term complications such as second malignancies and car diovascular diseases. The relatively high survival rates compared to o ther population-based studies may be attributable to the existence of a regional network within the frame-work of a comprehensive cancer cen tre. Better staging, new combinations of chemotherapy, improved radiat ion technology, advances in supportive care as well as more frequent i ntensive treatment of the elderly could explain the improvement in pro gnosis. (C) 1997 Elsevier Science Ltd.