An analysis of prognostic factors in early stage Hodgkin's disease.

Summary An analysis of prognostic factors has been carried out in 398 patients presenting with clinical Stage I and II Hodgkin's disease treated between 1963 and 1979. By life table analysis older age, lymphocyte depletion histology, systemic symptoms, mediastinal node bulk, and erythrocyte sedimentation rate (ESR)>40 mm/h were associated with a significantly worse survival probability. On multiple factor regression analysis only age and stage were independent prognostic variables for survival, with systemic symptoms having borderline significance. Using this information, together with other analyses of prognosis in early Hodgkin's disease [21, 54, 60] three groups of patients are defined. The first with a predicted 5-year survival of 78% would include patients possessing at least one of the following features; age >60, lymphocyte depletion, >3 sites involved, systemic symptoms, mediastinal/thoracic ratio of >1/3. The second groups present with at least two of the following factors; ESR >40 mm/h, male sex, 3 involved sites, or mixed cellularity histology, and the 5 year survival probability is 84%. The remaining Stage I and II patients would constitute a good prognosis group with a predicted 5-year survival of 92%.