SURVIVAL ANALYSIS OF PATIENTS WITH CLINICAL STAGE-I OR STAGE-II HODGKINS-DISEASE WHO HAVE RELAPSED AFTER INITIAL TREATMENT WITH RADIOTHERAPY ALONE

To aid treatment choice in early stage of Hodgkin's disease, we analys ed patients registered in the IDHD Database with clinical stages I or II Hodgkin's disease who were not staged with laparotomy and whose ini tial treatment was with radiotherapy alone. The factors analysed for o utcome after first relapse included initial stage, age, sex, histology , number of involved areas, mediastinal involvement, E-lesions, B-symp toms, erythrocyte sedimentation rate, alkaline phosphatase, serum albu min and haemoglobin. As well as presentation variables, we analysed th e disease-free interval after initial radiotherapy and the extent of d isease at relapse. A total of 1364 patients with clinical stage I of I I Hodgkin's disease were treated with initial radiotherapy, of whom 47 3 relapsed. The probability of survival 10 years after relapse was 63% . For cause-specific survival (CSS), both multivariate and univariate analysis identified the importance of age at presentation and histolog ical subtypes. When all causes of death were considered, the multivari ate analysis identified age as the only significant factor. The length of initial disease-free interval had no influence on prognosis after relapse, but the 169 patients with nodal relapse had a higher cause-sp ecific survival than those with an extranodal component of relapse (74 % versus 51% at 10 years, P < 0.005). Thus, the important factors for outcome after initial treatment with radiotherapy are those factors pr edicting the risk of relapse after initial treatment together with tho se predicting outcome after relapse, namely age, histologic subtype an d extent of disease at relapse. (C) 1997 Elsevier Science Ltd.