HODGKIN'S DISEASE: AN ANALYSIS OF FREQUENCY, DISTRIBUTION AND MORTALITY AT THE UNIVERSITY OF CALIFORNIA HOSPITAL, 1914-1951

Abstract

Statistics are presented regarding the age of onset, sex, duration of illness and mortality of 254 patients with Hodgkin''s disease seen at the University of California Hospital, 1914-1951, inclusive. The cases were divided into 3 stages, as follows: 38 patients with the disease clinically localized to 1 lymph node area, 110 patients with involvement of 2 or more lymph node areas, and 106 patients with disease clinically generalized beyond the lymphatic system. Data are compared with similar reports in the medical literature and with tabulations available in the Vital Statistics of the United States. From 1920 to 1950 there has been a progressive, consistent shift in the sex ratio toward a higher proportion of females, and a progressive, consistent shift toward a higher age at onset or at death of patients with Hodgkin''s disease. The duration of illness from Hodgkin''s disease in the California series, as determined from apparent onset to death, shows no significant change during the past 37 years. The mean survival of the total 254 patients was 44.3 months; the 5 year survival was 26.5%. When determined from date of diagnosis, the 5 year survival was 18.6% for 215 patients followed for 5 years. There was a significantly longer survival in 93 females than in 161 males; at 5 years after onset, 36.6% of the females and 20.9% of the males were alive. Three patients have remained clinically free of disease for 9 to 12 years after treatment. There was no significant correlation between survival and the age of onset. No statistically significant effect on survival could be correlated with various major forms of treatment and nitrogen mustard was shown to produce no prolongation of life. The implications of the study and recommendations for a nationwide program of endemiologic studies and therapeutic trials in Hodgkin''s disease and other lymphomas are discussed.