LATE RELAPSE AFTER TREATMENT FOR CLINICAL STAGE-I AND STAGE-II HODGKINS-DISEASE

BACKGROUND. Despite the excellent outcome for patients with early stag e Hodgkin's disease, late relapses do occur. The recognition of tile p attern and incidence of late relapse and subsequent outcome is more im portant to ensure tile provision of optimal care of patients with earl y stage Hodgkin's disease. METHODS. A review of 731 patients with clin ical stage [CS] I and II Hodgkin's disease treated at Princess Margare t Hospital over a 19-year period was undertaken to examine the charact eristics of patients who relapsed more than 4 years after the commence ment of initial therapy (late relapse). RESULTS. The actuarial surviva l for all patients was 76% at 10 years and disease free survival was 6 5%. There were 206 patients with relapse, and in 35 patients the relap se occurred late (4.0-15.3 years after initial therapy). From the time of relapse the 10-year survival was 46% after early relapse and 68% a fter late relapse. No prognostic factors predicting specifically for l ate relapse after treatment for CS I and II Hodgkin's disease were ide ntified in this study, although by multivariate logistic regression an alysis there was an increased proportion of large mediastinal masses i n the late relapse group. CONCLUSIONS. Late relapse is associated with a better survival than relapse occurring within the first 4 years fro m the time of diagnosis. (C) 1997 American Cancer Society.