Advance and stagnation in the treatment of patients with lymphoma and myeloma: Analysis using population-based cancer registry data in Japan from 1993 to 2006

Abstract

There have been significant advances in the treatment of patients with lymphoma and myeloma. Although the improvements in survival outcome have been clearly addressed by clinical trials, these studies includes patients who are otherwise healthy and would be eligible for trials that the actual improvement in survival in the general patient population over time is yet to be elucidated. Therefore, we reviewed the cancer-registry data of patients with lymphoma and myeloma in Japan from 1993 to 2006 and estimated relative survival (adjusted for competing causes of death in same-age members of the general population) according to three periods of diagnosis (1993-1997, 1998-2002 and 2003-2006). We also estimated conditional 5-year relative survival (5-year survival rate of patients who have survived 5 years). A total of 26,141 patients were reviewed and analyzed. Relative survival improved in Hodgkin lymphoma (HL, N=853, +20% improvement), diffuse large B-cell lymphoma (DLBCL, N=4,919, +14% improvement) and follicular lymphoma (FL, N=1,333, +13% improvement). In contrast, we found no significant improvement in survival since 1993 in peripheral T-cell lymphoma (PTCL, N=667, +4% improvement), adult T-cell leukemia/lymphoma (ATLL, N=2,166, -5% improvement) or multiple myeloma (MM, N=4,914, -2% improvement). Conditional 5-year survival of HL, DLBCL, FL, PTCL, ATLL and MM was 88, 87, 79, 63, 53 and 45%, respectively. Relative survival of patients with HL, DLBCL and FL significantly improved from 1993 to 2006 in Japan; in contrast, no improvement was seen in other diseases, suggesting unmet need of novel treatment strategies. What's new? Do advances in diagnosing and treating cancer translate into real improvements in survival among the population? These authors set out to measure improvements in survival using Japanese population-based cancer registry data from 1993 to 2006. Good news for those diagnosed with Hodgkin lymphoma, diffuse large B-cell lymphoma, or follicular lymphoma: relative survival has improved significantly for those cancers since 1993. They could detect no improvement in survival rates, however, for peripheral T-cell lymphoma, adult T-cell leukemia/lymphoma, or multiple myeloma, suggesting that there remains need for new strategies for treating those cancers.