Long Term Follow-Up Results for Patients with Hodgkin Lymphoma after First Remission of Longer Than Ten Years: A Population Based Study of 954 Patients from the British Columbia Cancer Agency.
Notice bibliographique
Résumé
Abstract Background Little information is available regarding the long-term follow-up results in patients with Hodgkin lymphoma (HL) after a first remission for 10 years or longer. The aim of this study is to evaluate the risk of disease relapse, secondary malignancy and causes of mortality in this cohort of patients. Results 954 patients with HL were identified by searching the BC Lymphoid Cancer Database for all patients diagnosed between 1960 and 1995 who had maintained a first remission of greater than 10 y. Median age at diagnosis was 27 y (range 3–73 y) with 83% of patients less than 44 y. Male:female ratio was 1.2:1. The clinicopathological characteristics of the whole cohort are summarized in table 1. The 20- and 30-year OS for the whole cohort were 84% and 64%, respectively. The 20- and 30-year DSS for the whole group were 99% and 98%, respectively. Significant risk factors for lower OS were male gender (20-year OS for males 81%, females 87%, p=0.03), age >44 at diagnosis (20-year OS for age >44 was 51%, <44 was 93%, p<.00001) and mixed cellularity (MC) (20-year OS 81%) compared with nodular sclerosing (NS) (20-year OS 90%), p=0.007. Those factors (sex, age and histological subtype) had no significant impact on the 20-year DSS or PFS. Disease stage and B symptoms had no impact on survival (OS, DSS and PFS). There is no significant difference in the 20- and 30-year OS, DSS or PFS between patients initially treated with radiotherapy alone, chemotherapy alone or a combination of both. Only 24 patients (2.5% of the whole group) had a HL relapse. Six patients had been treated with radiotherapy only, one with radio-chemotherapy and 17 with chemotherapy only. Twelve of these patients have died due to various causes (HL: 7, cardiac disease: 4, lung cancer: 1). There were no risk factors predictive for late relapse (age, stage, histologic type, initial treatment). Secondary cancer was observed in 169 patients (17%) with a median age at cancer diagnosis of 52 years. Extended field radiotherapy (n=108, 64%) and MOPP-like chemotherapy (n=72, 43%) were the most prevalent 2 factors in this group. Breast cancer was the most common malignancy (n=31, median age at diagnosis 47 years), followed by lung (n=25), gastrointestinal (n=21), gynecological (n=20), genitourinary (n=16), hematopoietic (n=15), and thyroid (n=6). In total, 165 patients (17% of the whole group) died after remission of more than 10 y of whom 113 (13% of the whole group) died due to potential complications of primary treatment. The two most common causes of death were secondary malignancies (n=79) and heart diseases (n=34). Only seven patients (0.7%) died due to HL relapse. Conclusion HL relapse is a rare event (< 3%) and death from HL very rare (< 1%) in those who remain in first remission for more than 10 y. Treatment related complications, such as secondary malignancy or ischemic heart disease, are the major causes of mortality. Summary of clinicopathological parameters of patients with HL in first remission for longer than 10 y Parameter Number (954)(%) *Limited: stage I/II, non-bulky (<10 cm in diameter) and no B symptoms. Histology Classical HL 858(90) Nodular sclerosing 610(65) Mixed cellularity 193(20) Lymphocyte-rich/depleted 42/13(4/1) Nodular lym. pred. 11(1) HL not specified 85(9) Stage:Limited*/advanced 445/509(47/53) B symptoms 239(25) Treatment Radiotherapy alone 357(37) Chemotherapy alone 258(27) Combination 337(35)
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».