Outcomes of lymphoma in South Australia, 1977–2007

Abstract

To determine survival rates of patients with lymphoma in South Australia. De-identified data from the SA Cancer Registry on all patients with lymphoma were analysed, as well as the subgroup treated at the Royal Adelaide Hospital (RAH). For non-Hodgkin lymphoma (NHL), we used the International Working Formulation (IWF) grading. SA and RAH data on survival rates were compared with those for the whole of Australia and the United States. All patients diagnosed with lymphoma and treated in SA in 1977-2007. 5-year survival rates for patients with lymphoma, by type of lymphoma and age. Of the total of 8651patients with lymphoma, 939were classified as having Hodgkin lymphoma (HL) and 7712as having NHL. Of those with NHL, 1805had low-grade, 3576intermediate-grade, and 510high-grade NHL. In another 1821patients, the data were insufficient to make an IWF grading. There was a substantial increase in 5-year survival rates for patients with lymphoma between 1977and 2007in SA. While the increase in 5-year survival rates for HL was 7.6percentage points, survival rates peaked at 88%. For NHL, there was an 18.7percentage points increase in 5-year survival rates. The first significant increase of 7percentage points was associated with the introduction of bone marrow transplantation; this was maintained with the increase in 5-year survival rates reaching 14percentage points by 1995-1999. Since 1999, there has been a further increase of 5percentage points in 5-year survival rates with the introduction of rituximab. Outcomes in patients with NHL have improved significantly, most likely because of the use of bone marrow transplantation and rituximab. Hospital- and state-based cancer registry data reflect the reality of population outcomes and the impact of new technologies.