Survival Rates in Cutaneous Lymphomas

GUnter Burg and Werner Kempf

Department of Dermatology, University Hospital, Zurich, Switzerland

The type of therapy employed—early aggressive vs. nonaggressive treatment modalities—does not have significant impact on disease-free or overall survival (1). In 650 cases from nine population-based cancer registries in the United States, the median survival time was 7.8 yr (2).

In a study of the EORTC group, survival times were evaluated retrospectively in 772 patients with cutaneous lymphoma (582 CTCL, 190 CBCL). Actuarial survival was 0.63 for both B- and T-cell lymphomas after 7yr and 0.52 for CTCL and 0.57 for CBCL after 10 yr (3).

Many differences in the survival rates of cutaneous lymphomas result from varying diagnostic concepts. In CTCL, the biggest variable is whether or not para-psoriasis, red man syndrome, or pre-Sezary-syndrome are included. In CBCL, the discrepancies concern the often difficult discrimination between pseudolymphoma (lymphoid hyperplasia) and malignant B-cell lymphoma, in particular of MALT type.

The following tables reflect some data from the literature (Table 1) and from the EORTC classification (Table 2), which is preferentially based on the material of the Dutch Lymphoma Group.

Table 3 gives some epidemiological data on cutaneous lymphoma, based on the EORTC-Registry 1982-1992 (12), classified according to the Kiel classification at that time (13).

These examples, even though informative, show the difficulties which result from frequent changes in classification concepts, especially if in addition different "organ-specific" classifications contribute to the Babylonian confusion.

Cutaneous lymphoma



Mycosis fungoides

Historical study of 144 cases by the NCI between

Observed SR at 5 yr: <30%

Sezary syndrome

1954 and 1969 (5)

Specific SR at 5yr: 45%

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