Tumour burden in early stage Hodgkin's disease: the single most important prognostic factor for outcome after radiotherapy

Specht, Lena; Nordentoft, A. M.; Cold, Søren; Clausen, Nielsaage Tøffner; Nissen, Nis I.

doi:10.1038/bjc.1987.109

Cited by 27 publications

(11 citation statements)

References 14 publications

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“…No single prognostic or treatment factor was predictive for relapse and only female sex independently predicted a shorter disease-free survival. Only two other studies have reported a significant sex difference (Tubiana et al, 1985;Specht et al, 1987) and in each case males had the poorer outcome.…”

Section: Discussionmentioning

confidence: 93%

“…A number of publications have addressed this problem and measures of treatment outcome (remission rates, disease-free survival, overall survival) have been linked to a range of prognostic factors. Multivariate analysis has revealed that many of these factors are interrelated and cannot be considered separately as indicators of outcome but are best regarded as each contributing to a measure of tumour burden (Cosset et al, 1984;Specht et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

“…Factors which predict the length of CR include B symptoms (Cosset et al, 1984;Tubiana et al, 1985;Longo et al, 1986), stage (Haybittle et al, 1985;Sutcliffe et al, 1984;Horwich et al, 1986), histology (Haybittle et al, 1985;Sutcliffe et al, 1984;Specht et al, 1987), number of disease sites (Cosset et al, 1984;Tubiana et al, 1985;Horwich et al, 1986), age (Sutcliffe et al, 1984;Tubiana et al, 1985;Longo et al, 1986), male sex (Tubiana et al, 1985;Specht et al, 1987), erythrocyte sedimentation rate (ESR) (Haybittle et al, 1985;Tubiana et al, 1985), tumour burden (Specht et al, 1987), number of extranodal sites (Longo et al, 1986), the presence of bulky mediastinal disease (Hoppe et al, 1982), time to achieve CR (Longo et al, 1986) and drug dose intensity (Pillai et al, 1985).…”

Section: Introductionmentioning

confidence: 99%

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A risk factor for relapse in Hodgkin's disease: Female gender?

Jeffery

Colls

Robinson

et al. 1989

Hematological Oncology

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A retrospective study of 163 patients with Hodgkin's disease treated between 1969 and 1987 was performed to identify adverse prognostic factors. One hundred and thirty-five patients (83 per cent) attained a complete remission and 42 (31 per cent) of these have relapsed (median follow-up--43 months). Using multivariate analysis, no independent factors predicted for the event of relapse. However, analysis of disease-free survival revealed that females fared significantly worse than males (p less than 0.05) and this was independent of other prognostic variables. Female sex has not been recognized as an independent prognostic factor predictive of inferior survival and inferior disease-free survival.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A risk factor for relapse in Hodgkin's disease: Female gender?

Jeffery

Colls

Robinson

et al. 1989

Hematological Oncology

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“…Peripheral and intrathoracic nodal tumour burden was assessed by a method described in earlier studies (16)(17)(18)(19). Peripheral and intrathoracic nodal tumour burden was assessed by a method described in earlier studies (16)(17)(18)(19).…”

Section: Methodsmentioning

confidence: 99%

Hodgkin's disease and age*

Specht

Nissen

1989

European J of Haematology

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506 unselected, previously untreated patients with Hodgkin's disease were treated at the Finsen Institute between 1969 and 1983. The prognostic significance of age, sex, stage, systemic symptoms, histologic subtype, number of involved nodal regions, total tumour burden (peripheral + intrathoracic nodal tumour burden, intraabdominal nodal tumour burden, and number of involved extranodal sites), pretreatment ESR, lymphocytopenia, and treatment modality were examined in multivariate analyses. The only factors of independent prognostic significance for disease‐free survival proved to be treatment modality, stage, and total tumour burden, whereas age had no prognostic significance. With regard to death from Hodgkin's disease only age and total tumour burden had independent significance. The significance of age would seem to stem from the fact that some older patients could not be given adequate treatment for relapse. The present study indicates that Hodgkin's disease in older patients is not prognostically very different from Hodgkin's disease in younger patients.

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“…86-076, and by the Boel Foundation. and I1 it has been shown that tumour burden, assessed by a fairly simple method combining the size of each involved region with the number of involved regions, is by far the most important prognostic factor (8)(9)(10).…”

Section: Accepted For Publicationmentioning

confidence: 99%

Prognostic factors in Hodgkin's disease stage III with special reference to tumour burden

Specht

Nissen

1988

European J of Haematology

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143 patients with Hodgkin's disease stage III (65 PS III, 78 CS III) were treated with radiotherapy alone (33 patients), combination chemotherapy alone (56 patients), or radiotherapy plus combination chemotherapy (54 patients). They were followed till death or from 7 to 191 months. Prognostic factors including treatment, peripheral + intrathoracic tumour burden (assessed by combining tumour size in each involved region with number of involved regions), intraabdominal tumour burden (assessed by combining size of lymphographically involved lymph nodes in each region with number of lymphographically involved regions), histologic subtype, B‐symptoms, number of involved regions, mediastinal involvement, pretreatment ESR, sex, age, laparotomy, and substage were examined in multivariate analysis. With regard to disease‐free survival, total tumour burden (intraabdominal and peripheral + intrathoracic) emerged as the only pre‐treatment factor of independent prognostic significance. With regard to overall survival the only factor of independent significance apart from age turned out to be intraabdominal tumour burden. The results of the present study thus support recently published findings regarding early stage disease to the effect that tumour burden is the single most important prognostic factor in Hodgkin's disease.

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Tumour burden in early stage Hodgkin's disease: the single most important prognostic factor for outcome after radiotherapy

Cited by 27 publications

References 14 publications

A risk factor for relapse in Hodgkin's disease: Female gender?

A risk factor for relapse in Hodgkin's disease: Female gender?

Hodgkin's disease and age*

Prognostic factors in Hodgkin's disease stage III with special reference to tumour burden

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