Bulky disease is the most important prognostic factor in Hodgkin lymphoma stage IIB
Bulky disease is the most important prognostic factor in Hodgkin lymphoma stage IIB
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DOI：
10.1034/j.1600-0609.2003.00108.x
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发表时间：
2003-11-01
影响因子：
3.1
通讯作者：
Enblad, G
中科院分区：
文献类型：
--
作者：
Glimelius, I;Molin, D;Enblad, G
本研究的目的是评估年龄小于60岁的霍奇金淋巴瘤（HL）患者的IIB期治疗结果，根据瑞典国家护理计划进行治疗。目的还在于根据患者具有的负面预后因素的数量来确定特定的亚组，以优化和区分未来的治疗。总共分析了1985年至1994年诊断的99例HL IIB期患者。有47名男性和52名女性，中位年龄为33岁（范围17-59）。86例患者出现膈上疾病，13例出现膈下疾病。HL特异性和总体10年生存率分别为73%和65%。病理IIB期患者的HL特异性生存率倾向于更好，尽管与临床IIB期相比无统计学显著性，尽管化疗较少（P = 0.1）。然而，选择剖腹手术的IIB期患者更年轻，不良预后因素更少。唯一显著的负性预后因素是巨大病变（P = 0.001）。国际预后评分、淋巴结转移数目、淋巴结转移和白细胞计数>15 × 10（9）/L也对预后有负面影响，但无统计学意义。总之，我们建议在治疗IIB期HL患者时，应考虑到巨大的疾病。
The aim of this study was to evaluate treatment results for Hodgkin lymphoma (HL) patients younger than 60 yr in stage IIB, treated according to the Swedish National Care Programme. The intention was also to identify specific subgroups depending on the number of negative prognostic factors the patients have, in order to optimise and differentiate future treatment. In total, 99 patients with HL stage IIB, diagnosed between 1985 and 1994, have been analysed. There were 47 men and 52 women and the median age was 33 yr (range 17-59). Eighty-six patients presented with supradiaphragmatic disease and 13 with infradiaphragmatic. The HL specific and overall 10-yr survival was 73 and 65%, respectively. The HL-specific survival for patients in pathological stage IIB tended to be better, although not statistically significant than for clinical stage IIB, despite less chemotherapy (P = 0.1). The patients in stage IIB who were selected for laparotomy were, however, younger and with fewer negative prognostic factors. The only significant negative prognostic factor was bulky disease (P = 0.001). The following factors also tended to have a negative influence on the prognosis although not statistically significant: the International Prognostic Score, the number of involved lymph node stations, extranodal involvement and leucocyte count >15 x 10(9)/L. In conclusion, we suggest that bulky disease should be taken into account when treating patients with stage IIB HL.