Survival statistics for non-Hodgkin lymphoma

Survival statistics for non-Hodgkin lymphoma (NHL) are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.

There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for NHL and what they mean to you.

Survival varies with each stage and particular type of NHL. There are more than 30 different types of NHL and each behaves and responds to treatment differently. Doctors will consider each type’s individual behaviour, prognostic factors and expected response to treatment before they make a prognosis.

Net survival represents the probability of surviving cancer in the absence of other causes of death. It is used to give an estimate of the percentage of people who will survive their cancer.

In Canada, the 5-year net survival for NHL is 68%. This means that about 68% of people diagnosed with NHL will survive for at least 5 years.

Survival varies with each stage, type of NHL and the number of poor prognostic factors defined by the IPI index. Generally, the earlier NHL is diagnosed and treated, the better the outcome. There are many effective treatments available for NHL and it often responds well to treatment.

There are no specific Canadian statistics available for the different stages or types of NHL. The following information comes from a variety of sources. It may include statistics from other countries that are likely to have similar outcomes as in Canada.

Experts have developed 2 prognostic indexes to predict the general outcome for fast-growing (aggressive) types of NHL and for follicular lymphoma. These indexes include progression-free survival and observed survival rates.

Progression-free survival is the length of time during and after treatment that people with a particular cancer live without the disease progressing, or becoming worse.

Observed survival, or overall survival, is the proportion of people with a particular cancer who are alive at a certain point in time.

The Revised International Prognostic Index (R-IPI) was developed to help determine the outcome for people with fast-growing types of NHL. It helps doctors assign people to risk groups based on how many of the following poor prognostic factors they have:

• older than 60 years of age
• the NHL is stage 3 or 4
• the lactate dehydrogenase (LDH) level is above normal
• the lymphoma cells have spread outside of the lymph nodes (called extranodal spread)
• a poor performance status

The Follicular Lymphoma International Prognostic Index (FLIPI) helps doctors assign people to low-, intermediate- or high-risk groups based on how many of the following poor prognostic factors they have:

• older than 60 years of age
• the NHL is stage 3 or 4
• the lactate dehydrogenase (LDH) level is above normal
• the hemoglobin level is less than 120g/L
• there are lymphoma cells in more than 4 lymph node areas

Talk to your doctor about your prognosis. A prognosis depends on many factors, including:

• your health history
• the type of cancer
• the stage of the cancer
• certain characteristics of the cancer
• the treatments chosen
• how the cancer responds to treatment

Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.