THE NATIONAL-CANCER-DATA-BASE REPORT ON NON-HODGKINS-LYMPHOMA

BACKGROUND. The National Cancer Data Base (NCDB) has reported on many malignancies occurring in men and women in the U.S. from >1400 contrib uting hospitals. The current report on non-Hodgkin's lymphoma (NHL) is a companion to an upcoming Patient Care Evaluation study of this rela tively common and serious cancer. METHODS, This report is comprised of all NHL cases submitted to the NCDB divided into two diagnostic-year groups: 1985-1988 and 1990-1993. Variables routinely collected by hosp ital cancer registries have been analyzed to report on patterns of dia gnosis and treatment. RESULTS. High grade NHL cases were more likely t o be Stage IV (40.8%) than were low or intermediate grade cases (34.8% and 32.5%, respectively). Patients with NHL arising from lymph node s ites tended to present with more advanced disease (55.8% with Stages I II and IV disease), whereas patients with NHL arising from extranodal sites and non-lymph node nodal sites presented at an earlier stage (64 .7% and 74.0%, respectively, with Stage I or Stage II disease). Approx imately 67% of all patients underwent chemotherapy, whereas only 25% u nderwent surgery or radiation. By histology, 5-year survival was 68.8% for low grade disease, 51.9% for intermediate grade disease, and 45.8 % for high grade disease; by stage, survival rates ranged from 73.5% f or Stage I to 42.9% for Stage TV disease. CONCLUSIONS. To the authors' knowledge, the 91,306 cases in this study represent the largest conte mporary sample of NHL patients. The material reported here may serve a s a reference with which to compare local patterns with national data. The Working Formulation's ability to stratify patients' survival rate s confirms its utility for NHL. Stage according to the American Joint Committee on Cancer also was accurate in predicting survival. (C) 1997 American Cancer Society.