Survival Rates and Prognostic Factors for Non-Hodgkin Lymphoma

Survival rates are a way to measure how many people survive a certain type of cancer over time. They cannot tell you what will happen with any one person, but they may help you better understand how likely it is that your treatment will be successful.

For some types of lymphoma, the stage alone doesn't tell doctors as much about a person's outlook or the best treatment plan. This is because these lymphomas often spread widely before they are found. Many people are diagnosed at a later stage.

In these cases, doctors also look at other prognostic factors to help predict outlook and guide treatment. These factors can include blood test results, age, and how well a person is able to carry out daily activities.

What is a 5-year relative survival rate?

A relative survival rate compares people with the same stage of a certain cancer to people in the overall population.

For example, if the 5-year survival rate for a specific stage of non-Hodgkin lymphoma is 80%, it means that on average, people who have that cancer are about 80% as likely as people who don't have that cancer to live 5 years after being diagnosed.

Of course, many people live much longer than 5 years.

Keep in mind that survival rates are estimates. These statistics can be confusing and might raise more questions for you. Ask your cancer care team how these numbers might apply to you.

Where do these numbers come from?

The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results (SEER) database to provide survival statistics for different types of cancer. This database is maintained by the National Cancer Institute (NCI).

The SEER database tracks 5-year relative survival rates for NHL in the United States, based on how far the cancer has spread. However, the database does not group cancers by the Lugano classification (stage I, stage II, stage III, etc.). Instead, it groups cancers into localized, regional, and distant stages.

• Localized: The cancer is limited to one lymph node area, one lymphoid organ, or one organ outside the lymph system.
• Regional: The cancer reaches from one lymph node area to a nearby organ, is found in 2 or more lymph node areas on the same side of the diaphragm (above or below), or is considered bulky disease.
• Distant: The cancer has spread to distant parts of the body, such as the lungs, liver, or bone marrow. Or, it has spread to lymph node areas above and below the diaphragm.

5-year relative survival rates for non-Hodgkin lymphoma

The overall 5-year relative survival rate for people with non-Hodgkin lymphoma (NHL) is 75%. But survival rates can vary widely for different types and stages of lymphoma.

The numbers below are based on people diagnosed with NHL in the United States between 2016 and 2022.

SEER* stage	5-year relative survival rate
Localized	87%
Regional	78%
Distant	67%

*SEER = Surveillance, Epidemiology, and End Results

Understanding the numbers

These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later if the cancer grows, spreads, or comes back after treatment.

These numbers don’t take everything into account. Survival rates for non-Hodgkin lymphoma are grouped based on how far the cancer has spread. But your outlook can be affected by your age, your overall health, the type of NHL you have, how well it responds to treatment, and other prognostic factors.

Treatments have improved over time. People now being diagnosed with NHL may have a better outlook than these numbers show. These numbers are based on people who were diagnosed and treated at least 5 years earlier.

Other prognostic factors

For some types of lymphoma, the stage of the cancer is not as helpful in determining a person’s prognosis (outlook). In this case, doctors might also use other prognostic factors to guide them as they plan treatment.

International Prognostic Index is the system used for many types of lymphoma. In this system, a person is assigned a risk group based on certain prognostic factors.

People in the low-risk group tend to have a better prognosis than those in the high-risk group.

International Prognostic Index (IPI)

This index includes 5 factors:

• Your age
• The stage of the lymphoma
• The presence of lymphoma in more than one organ outside the lymph system
• Performance status (PS): How well you can do everyday activities
• Serum LDH: The level of lactate dehydrogenase (LDH) in your blood. This level goes up with the amount of lymphoma in the body.

Good prognostic factors	Poor prognostic factors
Age 60 or below	Age above 60
Stage I or II	Stage III or IV
No lymphoma outside of lymph nodes, or lymphoma in only 1 area outside of lymph nodes	Lymphoma is in more than 1 organ of the body outside of lymph nodes
PS: Able to function normally	PS: Needs a lot of help with daily activities
Serum LDH is normal	Serum LDH is high

 

How to read this index

Each poor prognostic factor is assigned 1 point. The index divides people into 4 risk groups based on the number of poor prognostic factors they have.

• Low risk: 0 or 1 poor prognostic factors
• Low-intermediate risk: 2 factors
• High-intermediate risk: 3 factors
• High risk: 4 or 5 factors

Doctors might also use other versions of this index, depending on the type of lymphoma and the treatment being used.

Some types of lymphoma, such as follicular lymphoma and mantle cell lymphoma, have their own prognostic indexes. Ask your care team which index applies to you and what your risk group means for your treatment.