ISSN:
1569-8041
Keywords:
cardiac
;
complications
;
Hodgkin's disease
;
mortality
;
secondary cancers
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: The long-term survival of patients treated for Hodgkin'sdisease permits careful evaluation of long-term complications and excessmortality. Patients and methods: Between 1960 and 1995, 2498 patients who weretreated for Hodgkin's disease at Stanford University were evaluated. Survival,freedom from relapse, and important complications of therapy (cardiac diseaseand secondary cancers) were analyzed, and risk of mortality from all causeswas calculated utilizing absolute excess risk calculations. Results: The risk of death from Hodgkin's disease is 17% at15 years of follow-up and increases only slightly thereafter. The risk ofdeath from other causes is also 17% at 15 years, but increases sharplythereafter. The major causes of mortality (other than Hodgkin's disease) aresecondary cancers and cardiac disease. Second cancers with significantincrease in risk include leukemia (acute nonlymphocytic), non-Hodgkin'slymphoma, lung/pleural cancer, breast cancer, melanoma, soft tissue and bonesarcomas, stomach cancer, salivary gland tumors, thyroid cancer, andpancreatic cancer. The absolute excess risk of death from causes other thanHodgkin's disease increases during each five-year follow-up interval for atleast 25 years. However, the absolute excess risk of death during similarfollow-up periods is less for patients treated in more recent years(1980–1995) than in the prior treatment era (1962–1980). Conclusions: Mortality for causes other than Hodgkin's disease isimportant in the long-term follow-up of patients. Causes of death are oftentreatment related. Changes in treatment programs can reduce the long-termexcess risk of death from complications of therapy.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008238908676
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