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Prognostic value of event‐free survival at 12 and 24 months and long‐term mortality for non‐Hodgkin follicular lymphoma patients: A study report from the Spanish Lymphoma Oncology Group
Author(s) -
Provencio Mariano,
Royuela Ana,
Torrente María,
Pollán Marina,
GómezCodina José,
Sabín Pilar,
Llanos Marta,
Gumá Josep,
Quero Cristina,
Blasco Ana,
Aguiar David,
GarcíaArroyo Francisco Ramón,
Lavernia Javier,
Martínez Natividad,
Morales Manuel,
SaenzCusi Álvaro,
Rodríguez Delvys,
Calvo Virginia,
CruzMerino Luis,
Cruz Miguel Ángel,
Rueda Antonio
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30795
Subject(s) - medicine , population , standardized mortality ratio , confidence interval , follicular lymphoma , lymphoma , mortality rate , hodgkin lymphoma , survival analysis , environmental health
BACKGROUND Relatively few studies have analyzed the mortality of follicular lymphoma (FL) patients in comparison with a sex‐ and age‐matched general population. This study analyzed the overall survival (OS) of patients with FL and compared their survival with the expected survival of a general population. METHODS Patients diagnosed with FL were prospectively enrolled from 1980 to 2013. Standardized mortality ratios (SMRs) were obtained from yearly sex‐ and age‐specific mortality rates in Spain, and OS was compared with age‐ and sex‐matched general population data. RESULTS A total of 1074 patients with newly diagnosed FL were enrolled. The median OS was 231 months (95% confidence interval [CI], 195‐267 months). Event‐free survival at 12 months (EFS12) and event‐free survival at 24 months (EFS24) were associated with an increased probability of early death, with an SMR of 10.27 (95% CI, 8.26‐12.77) for EFS12. The overall SMR, including all causes of death, was 2.55 (95% CI, 2.23‐2.92), and it was higher for women (SMR, 3.02; 95% CI, 2.48‐3.67) and young adults (SMR, 6.01; 95% CI, 3.13‐11.55). More than 10 years after the diagnosis, mortality rates for FL patients were lower than those for the general population (SMR, 0.47; 95% CI, 0.28‐0.78). When FL was excluded as a cause of death, the overall SMR was 1.35 (95% CI, 1.11‐1.65) without a statistically significant mortality increase in the >60‐year‐old group in comparison with age‐ and sex‐matched general population data. More than 15% of the patients included in the study (n = 158) had more than 10 years of follow‐up. CONCLUSIONS EFS12 and EFS24 predict an early increase in mortality. The long‐term SMR, over the course of 10 years of follow‐up, shows that patients with FL have a risk of dying similar to that of a sex‐ and age‐matched general population. Cancer 2017;123:3709–3716. © 2017 American Cancer Society