Conditional Survival and Annual Hazard Estimates of Classical Hodgkin Lymphoma.
Conditional Survival and Annual Hazard Estimates of Classical Hodgkin Lymphoma.
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经典霍奇金淋巴瘤的条件生存率和年度危害估计
DOI：
10.2147/cmar.s324543
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发表时间：
2021
影响因子：
3.3
通讯作者：
Zhu J
中科院分区：
文献类型：
--
作者：
Nuersulitan R;Yang M;Mi L;Wu M;Liu X;Ping L;Xie Y;Liu W;Song Y;Zhu J
在目前的研究中，我们试图通过采用条件生存和年度危险作为预后和生存的动态估计，了解经典霍奇金淋巴瘤患者的风险水平和生存概率如何随时间变化。本回顾性研究回顾了2008年1月1日至2017年12月31日北京大学肿瘤医院收治的新诊断经典霍奇金淋巴瘤患者的临床资料。假设患者存活一定时间，将条件生存和年危险率分别定义为生存概率和年事件率。共纳入384例患者（中位年龄32岁，范围6-77岁），其中218例（56.8%）患者为早期疾病。中位随访时间为41.3个月。5年的条件总生存率（COS）保持良好，从治疗时的89%增加到第5年的94%，而5年的条件无失败生存率（CFFS）从治疗时的70%增加到第5年的96%。每年的失败风险从诊断时的15%以上下降到3年后的5%以下。早期患者的死亡风险（范围0-3.0%）和衰竭风险（范围0-14.3%）的年度估计值不断降低。然而，晚期患者的失败风险从诊断时的24.2%下降到3年后的8%以下，而死亡风险始终处于相对较低的水平。IPS风险评分高（≥3）的患者在前4年的COS和CFFS显著降低。接受BEACOPP方案的患者比接受ABVD方案的患者有更好的5年COS和5年CFFS。随着时间的推移，存活率增加，失败的危险降低。
In the present study, we have tried to understand how the level of risk and survival probability changes over time for patients with classical Hodgkin’s lymphoma by employing conditional survival and annual hazard as dynamic estimates of prognosis and survival. This retrospective study reviewed the clinical data of patients with newly diagnosed classical Hodgkin’s lymphoma admitted to Peking University Cancer Hospital between January 1, 2008, and December 31, 2017. Conditional survival and annual hazard rate were defined as the survival probability and yearly event rate, respectively, assuming that patients have survived for a defined time. A total of 384 patients were included (median age, 32 years; range, 6–77 years), of which 218 (56.8%) patients had early-stage disease. The median follow-up time was 41.3 months. The 5-year conditional overall survival (COS) rates remained favorable and showed an increase from 89% at treatment to 94% at year 5, while the 5-year conditional failure-free survival (CFFS) rate increased from 70% at treatment to 96% at year 5. The annual hazard of failure decreased from over 15% at diagnosis to less than 5% after 3 years. Early-stage patients had constantly lower annual estimates for hazard of death (range, 0–3.0%) and failure (range, 0–14.3%). However, the hazard of failure in advanced-stage patients decreased from 24.2% at diagnosis to below 8% after 3 years, whereas the hazard of death was always at relatively low levels. Patients with a high IPS risk score (≥3) had significantly lower COS and CFFS during the first 4 years. Patients who received the BEACOPP regimen had better 5-year COS and 5-year CFFS than those who received the ABVD regimen. The survival probability increased and hazard of failure decreased over time.