1. Survival improved for most types of hematologic malignancies in Europe between 1992 and 2007.
2. The improvements in survival for various malignancies were not geographically uniform throughout the European continent.
Evidence Rating Level: 2 (Good)
Study Rundown: Recent advancements in the treatment of hematologic malignancies, including the introduction of drugs such as rituximab, imatinib, and bortezomib, have changed the survival outlook for many patients. Prior to this study, there had been no large scale examinations of survival trends in patients with hematologic malignancies in Europe. The authors of this study set out to describe the 5-year survival for each different type of malignancy in addition to estimating the relative excess risk of death 5 years following diagnosis stratified by age, time period, and continental region. The study found an overall improvement in survival throughout the European continent. The improvements were not geographically uniform. This study benefited from the fact that patient data were drawn from large cancer registries, representing geographic regions as a whole rather than information gathered from individual centers of excellence. A drawback to this study is that little to no information was collected regarding confounding variables such as treatment type, stage of diagnosis, or comorbidities.
In-Depth [retrospective cohort]: This study included 560,444 individuals greater than 15 years of age with hematologic malignancies from the EUROCARE-5 database between 1996 and 2007. Non-Hodgkin lymphoma was the most common malignancy (40.1%) followed next by myeloid malignancies (24.9%), multiple myeloma/plasmacytoma (15.0%), not otherwise specified (13.7%), and Hodgkin’s lymphoma (6.3%).
5-year survival increased significantly over the study period for all lymphoid malignancies with follicular lymphoma and large B-cell lymphoma having the largest increases, (58.9% [95% confidence interval, CI, 57.3-60.6] in 1997-99 to 74.3% [95% CI, 72.9-75.5] in 2006-08 and 29.8% [95% CI, 27.7-32.0] in 1997-99 to 41.1% (95% CI, 39.0-43.1) in 2006-08, respectively, p < 0.0001). Younger patients tended to have better 5-year survival than older patients as well as having a greater increase in survival over the study period.
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