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Anatomical substages of stage III Hodgkin's disease. Implications for staging, therapy, and experimental design
Author(s) -
Stein Richard S.,
Hilborn Richard M.,
Flexner John M.,
Bolin Marion,
Stroup Steven,
Reynolds Ver,
Krantz Sanford
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197808)42:2<429::aid-cncr2820420208>3.0.co;2-y
Subject(s) - stage (stratigraphy) , medicine , disease , abdomen , radiation therapy , spleen , surgery , paleontology , biology
Twenty‐three patients with pathologic stage III Hodgkin's disease were classified with respect to the presence or absence of symptoms (III‐A, III‐B), the presence or absence of splenic involvement (IIIS+, IIIS‐) and anatomic substage—the extent of disease within the abdomen (III 1 , III 2 ). Stage III 1 disease included disease limited to the upper abdomen, i.e., spleen, splenic node, celiac node, and/or portal node. All other more extensive disease was classified as stage III 2 . Symptoms and splenic involvement did not predict either disease‐free survival or survival. However, 5 year actuarial disease‐free survival was significantly better in III 1 patients as compared to III 2 patients (77% vs. 13%, p < 0.001). Eight of nine stage III 2 patients receiving total nodal radiotherapy alone relapsed. When considered along the previous studies of anatomic substage, these findings suggest that patients in stage III 1 and III 2 should receive different therapeutic approaches. Analysis of therapeutic results in stage III patients must consider anatomic substage.