Expected Long-Term Survival of Older Patients Diagnosed with Non-Hodgkin Lymphoma in 2007-2011.

New therapeutic options have led to substantial increases in survival expectations of patients with non-Hodgkin lymphoma (NHL) in recent years. In contrast to many malignancies, survival in older patients has improved in NHL at a rate similar to that in younger patients. In the past, the impact of these innovations on long-term survival of NHL patients on the population level has only been disclosed with substantial delay. In order to reduce this delay, we employed a newly developed projection method to estimate survival of patients age 60 and older with NHL in 2007-11.

In order to demonstrate the validity of model based projection, we calculated survival for 4 prior periods for which observed 5-year survival data is available by three methods: cohort analysis, period analysis, and model based projection and compared the results to the actual observed survivals from the same time periods. We next calculated survival estimates for the most recent patient cohort for which 5- and 10-year survival data is available, period analysis for 2002-06, and projection estimates for 2007-11.

A preliminary empirical evaluation of the method using historical data indicated good performance in projection of age specific and overall 5- and 10-year relative survival in older patients with model based projection giving a result closer to the observed survival than either cohort analysis or period analysis for all age groups in each time period. Five and 10-year survival estimates for 2007-11 for patients aged 60+ were 65.1% and 53.5%, respectively, 8.9 percentage units (% units) and 14.8% units, respectively, higher than survival estimated from the most recent cohort analysis available (see table). Age specific 5- and 10-year relative survival estimates using model based projection ranged from 76.9% and 66.6%, respectively, for age 60-64 to 50.7% and 37.5%, respectively, for patients age 80+. Survival estimates by model based projection were higher for all age groups including 80+, both high and low grade disease, nodal and extranodal disease, and both genders.

Patients over 60 diagnosed with NHL in 2007-2011 have much higher long-term survival expectations than suggested by previously available survival statistics. The use of model based projection is reliable in this patient population and demonstrates steady improvement in survival over time for older patients with NHL. This reinforces the findings from clinical trials which show that treatment of NHL is tolerable and effective in older patients.

No relevant conflicts of interest to declare.