Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study.
Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study.
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霍奇金淋巴瘤合并胃肠癌患者的长期生存：一项基于人群的研究。
DOI：
10.1093/annonc/mds218
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Travis,LB
中科院分区：
文献类型：
--
作者：
Youn,P;Li,H;Milano,MT;Stovall,M;Constine,LS;Travis,LB
背景霍奇金淋巴瘤(HL)后胃肠道(GI)癌风险增加已得到证实。209例HL-GI癌患者(105例结肠癌，35例胃癌，30例胰腺癌，21例直肠癌，18例食道癌)和484例165例首次原发GI癌(GI-1)患者的精算生存率进行了比较，其中包括年龄，性别，种族，GI癌分期，HL的放射治疗，以及其他变量。结果虽然发生局部期结肠癌的HL患者的生存率与GI-1组相似，合并区域或远处结肠癌的HL患者的总生存期(OS)降低[风险比(HR)=11.46，P=0.01]。合并横结肠癌的区域或远期结肠癌的HL存活者死亡率特别高(HR：2.7，P=0.0.001)。在局限性胃癌患者中，生存的HL患者的OS较差(HR=3.46，P=0.006)。结论与首发原发GI癌患者相比，发生GI癌的HL患者的生存率显著降低。需要进一步的研究来解释HL患者存活率较低的原因，并确定HL幸存者癌症筛查的选择标准。
BackgroundThe increased risk of gastrointestinal (GI) cancers after Hodgkin's lymphoma (HL) is well established. However, no large population-based study has described the actuarial survival after subsequent GI cancers in HL survivors (HL-GI).Patients and methodsFor 209 patients with HL-GI cancers (105 colon, 35 stomach, 30 pancreas, 21 rectum, and 18 esophagus) and 484 165 patients with first primary GI cancers (GI-1), actuarial survival was compared, accounting for age, gender, race, GI cancer stage, radiation for HL, and other variables.ResultsThough survival of HL patients who developed localized stage colon cancer was similar to that of the GI-1 group, overall survival (OS) of HL patients with regional or distant stage colon cancer was reduced [hazard ratio, (HR) = 1.46,P= 0.01]. The HL survivors with regional or distant stage colon cancer in the transverse segment had an especially high risk of mortality (HR: 2.7,P= 0.001 for OS). For localized stomach cancer, OS was inferior among HL survivors (HR = 3.46,P= 0.006).ConclusionsThe HL patients who develop GI cancer experience significantly reduced survival compared with patients with a first primary GI cancer. Further research is needed to explain the inferior survival of HL patients and to define selection criteria for cancer screening in HL survivors.