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Anatomic Substages of Stage III-A Hodgkin's Disease: A Collaborative Study

RICHARD S. STEIN, M.D.; HARVEY M. GOLOMB, M.D.; CHARLES H. DIGGS, M.D.; PETER MAUCH, M.D.; SAMUEL HELLMAN, M.D.; PETER H. WIERNIK, M.D.; JOHN E. ULTMANN, M.D.; and DAVID S. ROSENTHAL, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Richard S. Stein, M.D.; Department of Medicine, Room A3311, Vanderbilt University School of Medicine, 21st Avenue at Garland; Nashville, TN 37232.


Nashville, Tennessee; Chicago, Illinois; Baltimore, Maryland; and Boston, Massachusetts


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;92(2_Part_1):159-165. doi:10.7326/0003-4819-92-2-159
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The clinical significance of anatomic substage was assessed in 130 patients with Hodgkin's disease in pathologic stage III-A: stage III-A includes involvement of spleen, or splenic, celiac, or portal nodes, or any combination of these; stage III-A includes involvement of para-aortic, iliac, or mesenteric nodes, with or without upper abdominal involvement. Median follow-up was 58 months. Both 5-year disease-free survival, 74% versus 46%, and 5-year survival, 94% versus 65%, were better (P < 0.001) in stage III-A than in stage III2-A. In stage III,-A, 5-year disease-free survival was better in patients receiving radiotherapy and chemotherapy than in patients receiving radiotherapy alone as initial treatment, 96% versus 63%, P < 0.003; however, 5-year survival rates in these treatment groups were similar, 100% versus 91%, P = 0.22. For stage III2-A, both 5-year disease-free survival, 76% versus 32%, P < 0.001, and 5-year survival, 84% versus 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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