Anatomic Substages of Stage III-A Hodgkin's Disease

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Abstract
The clinical significance of anatomic substage was assessed in 130 patients with Hodgkin''s disease in pathologic stage III-A; stage III1-A includes involvement of spleen, or splenic, celiac or portal nodes, or any combination of these; stage III2-A includes involvement of para-aortic, iliac or mesenteric nodes, with or without upper abdominal involvement. Median follow-up was 58 mo. Both 5 yr disease-free survival, 74 vs. 46%, and 5 yr survival, 94 vs. 65%, were better (P < 0.001) in stage III1-A than in stage III2-A. In stage III1-A, 5-yr disease-free survival was better in patients receiving radiotherapy and chemotherapy than in patients receiving radiotherapy alone as initial treatment, 96 vs. 63%, P < 0.003; 5-yr survival rates in these treatment groups were similar, 100 vs. 91%, P = 0.22. For stage III2-A, both 5-yr disease-free survival, 76 vs. 32%, P < 0.001 and 5-yr survival, 84 vs. 56%, P < 0.03, were superior with radiotherapy-chemotherapy. Consideration of anatomic substage may aid therapeutic planning for stage III Hodgkin''s disease.

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