Retrospective Analysis of Treatment Outcome and Prognostic Factors in Hodgkin's Disease.
- Author:
Sang Won LEE
1
;
Baek Yeol RYOO
;
Bong Seog KIM
;
Yeon Hee PARK
;
Tae You KIM
;
Young Hyuck IM
;
Young Woo LEE
;
Hyun Ju HONG
;
Jin Young KWAG
;
Yoon Koo KANG
Author Information
1. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Hodgkin's disease;
Treatment outcome;
Prognostic factor
- MeSH:
Academies and Institutes;
Disease-Free Survival;
Drug Therapy;
Drug Therapy, Combination;
Hodgkin Disease*;
Humans;
Korea;
Laparotomy;
Lymph Nodes;
Prognosis;
Radiotherapy;
Retrospective Studies*;
Survival Rate;
Treatment Outcome*
- From:Korean Journal of Hematology
1999;34(4):549-558
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The prognostic outlook for Hodgkin's disease has markedly improved in recent decades and 70 to 80% of patients can be cured with the modern combination chemotherapy. However, there is no standard treatment strategy according to each stage of the disease. In the present work we analysed retrospectively the therapeutic outcomes of 66 newly diagnosed patients with Hodgkin's disease treated with the strategy of Korea Cancer Center Hospital (KCCH) between 1989 and 1998. Also we studied to identify prognostic factors influencing the therapeutic outcome of the disease. METHODS: The treatment strategy of our institute was as follows; Patients in clinical stage IA with cervical, inguinal or mediastinal involvement and favorable histology (lymphocyte predominant) received radiotherapy without staging laparotomy. However, other patients of IA and the patients in IB, IIA, IIB, IIIA1 were recommended staging laparotomy to determine pathologic stage. The patients who were contraindicated to or refused staging laparotomy, or who were in clinical stage IIIA2, IIIB, IVA, IVB received chemotherapy. The patients in pathologic stage I or II received radiotherapy, and who in IIIA, IIIB, IIB, IV were treated with chemotherapy. The patients who have had massive tumor in any stage received additional radiotherapy following chemotherapy and who had residual lymph node after chemotherapy received additional radiotherapy to involved area. RESULTS: Of all 66 patients, 13 patients received radiotherapy alone and 53 patients were treated with chemotherapy +/- radiotherapy. Staging laparotomy was performed in 6 patients and pathologic stage tended to be upstaged after laparotomy. A complete response (CR) rate following treatments was reached to 81.8% (54/66, 95% C.I.=72.3~91.3%). Five-year progression free survival and overall survival rate were 59.1% and 74.3%, respectively. In prognostic factors analysis, age (P=0.0323) and performance status (P=0.0183) were the independent prognostic factors influencing overall survival. CONCLUSION: The outcome of Hodgkin's disease treated with our strategy was as good as that in other institutes. However, the prognosis of the patients who did not reach complete remission was poor. The prognostic factors analysis showed that age and performance status, which were not considered in establishment of treatment strategy, were the independent factors influencing the outcome of Hodgkin's disease. Further studies to develop treatment strategy considering all important prognostic factors including age and performance status and to increase complete response rate and ultimately overall outcome were warranted.
