SALVAGE OF RELAPSE OF PATIENTS WITH HODGKINS-DISEASE IN CLINICAL STAGE-I OR STAGE-II WHO WERE STAGED WITH LAPAROTOMY AND INITIALLY TREATED WITH RADIOTHERAPY ALONE - A REPORT FROM THE INTERNATIONAL DATABASE ON HODGKINS-DISEASE

Purpose: To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing af ter initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy. Methods and Materials: Data were a nalyzed on 681 patients in the International Database on Hodgkin's Dis ease who were initially in clinical Stages I or II, who were staged wi th laparotomy, and who relapsed after initial treatment with irradiati on alone. Factors analyzed for outcome after first relapse included in itial stage, age, sex, histology, presentation (supra- vs. infradiaphr agmatic), number of involved areas, mediastinal involvement, E-lesions , B-symptoms, erythrocyte sedimentation rate, lactate dehydrogenase, a lkaline phosphatase, serum albumin, and hemoglobin. Results: Only age and histology showed significant prognostic impact in univariate and m ultivariate analyses. The influence of age may perhaps be attributed t o suboptimal treatment of some older patients. Patients with nodal rel apse had a better prognosis than patients with extranodal relapse, pro bably indicating that the latter had more extensive disease at relapse . The length of the initial disease-free interval had no influence on prognosis after relapse. Conclusion: The decisive factors for outcome after initial treatment with irradiation alone are a) the factors pred icting the risk of relapse after initial radiotherapy and b) the facto rs predicting outcome after relapse, that is, histologic subtype and e xtent of disease at relapse.