Relative survival of patients with lymphoma in queensland according to histological subtype

Abstract

Objective: To evaluate relative survival of patients in Queensland with different lymphoma subtypes; to determine whether outcomes have improved with recent changes in treatment; to evaluate relative survival according to place of residence and socio-economic status. Design: Retrospective population-based study; analysis of data from the Oncology Analysis System, an online reporting tool for cancer incidence and outcomes in Queensland. Participants: Patients over 15 years of age diagnosed with lymphoma in Queensland during 1993−2012. Main outcome measures: Relative survival by lymphoma subtype; influence of place of residence and socio-economic status, age group, sex, year of diagnosis (in 5-year bands), and Pharmaceutical Benefits Scheme funding of rituximab for treating B-cell lymphomas on relative survival. Results: 9509 people (56% men) were diagnosed with lymphoma during 1993−2012. Five-year relative survival improved significantly between 1993−1997 and 2008−2012 for patients with diffuse large B-cell lymphoma (47%; 95% CI, 42−51% v 64%; 95% CI, 61−67%) or follicular lymphoma (62%; 95% CI, 57−66% v 88%; 95% CI, 85−90%; each P < 0.001). Rituximab became available for treating these subtypes during 2003−2006. There was no change in relative survival for patients with Hodgkin lymphoma (81%; 95% CI, 76−85% v 80%; 95% CI, 75−84%; P = 0.22). The only statistically significant difference according to place of residence or socio-economic status was inferior relative survival for rural residents with diffuse large B-cell lymphoma (hazard ratio, 1.14; 95% CI, 1.01−1.28). Conclusion: Relative survival for patients with B-cell non-Hodgkin lymphoma improved significantly with the introduction of rituximab as first-line therapy in Australia.