Inferior outcomes and treatment disparities in elderly patients with classical Hodgkin lymphoma: a national cancer data base analysis
| Autor: | Ajay Major, Rachel Rabinovitch, Derek E. Smith, Manali Kamdar, Matthew W. Jackson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Adolescent MEDLINE macromolecular substances Kaplan-Meier Estimate 03 medical and health sciences Young Adult 0302 clinical medicine immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols polycyclic compounds medicine Classical Hodgkin lymphoma Humans Public Health Surveillance Healthcare Disparities Base (exponentiation) Aged Neoplasm Staging Proportional Hazards Models Aged 80 and over business.industry food and beverages Disease Management Hematology Middle Aged Prognosis Hodgkin Disease Cancer data Treatment Outcome 030220 oncology & carcinogenesis Female business Delivery of Health Care 030215 immunology |
| Zdroj: | Leukemialymphoma. 60(5) |
| ISSN: | 1029-2403 |
| Popis: | Elderly patients with classical Hodgkin lymphoma (cHL) are understudied and poorly defined. The National Cancer Data Base was queried for adults with cHL diagnosed 2004-2013: 22,547 age 18-39, 12,841 age 40-59, and 10,873 age ≥60 were identified. Two-year overall survival (OS) was 97%, 91%, and 65% for the three age cohorts, respectively (p .0001). Elderly patients age ≥60 had greater advanced comorbidity scores, stage III-IV disease, and lymphocyte-depleted histology. Elderly patients were treated less with chemotherapy, radiotherapy for stage I-II disease, and at academic/research centers (p .001). There was improved OS in elderly patients who received chemotherapy and/or radiotherapy and were treated at academic/research centers. This largest analysis of elderly cHL demonstrates that patients ≥60 are distinct from those 40-59. Age ≥60 should be a stratification in future trials and merit distinct studies. Improving the poor rate of treatment delivery and directing care to academic centers may improve outcomes. |
| Databáze: | OpenAIRE |
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