Open AccessOverall and disease‐specific survival of Hodgkin lymphoma survivors who subsequently developed gastrointestinal cancer
Author(s) -
Rigter Lisanne S.,
Schaapveld Michael,
Janus Cecile P. M.,
Krol Augustinus D. G.,
Maazen Richard W. M.,
Roesink Judith,
Zijlstra Josee M.,
Imhoff Gustaaf W.,
Poortmans Philip M. P.,
Beijert Max,
Lugtenburg Pieternella J.,
Visser Otto,
Snaebjornsson Petur,
Eggermond Anna M.,
Aleman Berthe M. P.,
Leeuwen Flora E.,
Leerdam Monique E.
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1922
Subject(s) - medicine , hazard ratio , interquartile range , gastroenterology , cancer , proportional hazards model , confidence interval , gastrointestinal cancer , cohort , colorectal cancer , radiation therapy , chemotherapy , oncology
Background Hodgkin lymphoma (HL) survivors have an increased risk of gastrointestinal (GI) cancer. This study aims to evaluate whether survival of patients who survived HL and developed GI cancer differs from survival of first primary GI cancer patients. Methods Overall and cause‐specific survival of GI cancer patients in a HL survivor cohort (GI‐HL, N = 104, including esophageal, gastric, small intestinal, and colorectal cancer) was compared with survival of a first primary GI cancer patient cohort (GI‐1, N = 1025, generated by case matching based on tumor site, gender, age, and year of diagnosis). Cox proportional hazards regression was used for survival analyses. Multivariable analyses were adjusted for GI cancer stage, grade of differentiation, surgery, radiotherapy, and chemotherapy. Results GI‐HL cancers were diagnosed at a median age of 54 years (interquartile range 45‐60). No differences in tumor stage or frequency of surgery were found. GI‐HL patients less often received radiotherapy (8% vs 23% in GI‐1 patients, P < 0.001) and chemotherapy (28% vs 41%, P = 0.01) for their GI tumor. Compared with GI‐1 patients, overall and disease‐specific survival of GI‐HL patients was worse (univariable hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.03‐1.65, P = 0.03; and HR 1.29, 95% CI 1.00‐1.67, P = 0.049, respectively; multivariable HR 1.33, 95% CI 1.05‐1.68, P = 0.02; and HR 1.33, 95% CI 1.03‐1.72, P = 0.03, respectively). Conclusions Long‐term overall and disease‐specific survival of GI cancer in HL survivors is worse compared with first primary GI cancer patients. Differences in tumor stage, grade of differentiation, or treatment could not explain this worse survival.