19 October 2006

1
The CCCW population based non-Hodgkin lymphoma
registry long term follow-up, relative survival
and secondary cancer risk.

• 19 October 2006
• Comprehensive Cancer Centre West (Leiden)
• L.G.M van der Geest (CCCW), S. le Cessie (LUMC),
  W.M. Kloosterman-Boele (CCCW), A.D.G. Krol (LUMC)

Comprehensive Cancer Centre West, Leiden
2
NHL database

• Population based registry of non-Hodgkin
  lymphomas 1981-1989 (n1168)
• Extensive diagnostic and therapeutic data, e.g.
  treatment respons, recurrences, second
  malignancies, cause of dead
• Last follow up in 2005

Comprehensive Cancer Centre West, Leiden
3
Methods

• Survival of NHL subgroups
• Kaplan Meier curves
• Relative survival rates
• Second malignancies
• Calculating expected numbers of second
  malignancies using person years
• Standardized Morbidity Rates

Comprehensive Cancer Centre West, Leiden
4
Cumulative survival compared to general population
Statistics Netherlands
NHL
Comprehensive Cancer Centre West, Leiden
5
Survival NHL subgroups (KM)
follicular
diffuse large B-cell
other
Comprehensive Cancer Centre West, Leiden
6
Excess mortality in NHL subgroups
Comprehensive Cancer Centre West, Leiden
7
Causes of death
Comprehensive Cancer Centre West, Leiden
8
Causes of death in subgroups
Comprehensive Cancer Centre West, Leiden
9
Causes of death in subgroups
Comprehensive Cancer Centre West, Leiden
10
Competing risk on second malignancy
Comprehensive Cancer Centre West, Leiden
11
Second malignancies (n100)
Comprehensive Cancer Centre West, Leiden
12
Standardized Morbidity Rates(SMR)
Comprehensive Cancer Centre West, Leiden
13
Standardized Morbidity Rates(SMR)
Comprehensive Cancer Centre West, Leiden
14
Conclusions

• Difference in survival pattern NHL subgroups
• Continuing excess mortality
• Second malignancies in respiratory and blood
  system higher than expected

Comprehensive Cancer Centre West, Leiden