PURPOSE: To report long-term follow-up results and to analyze prognostic factors for overall and disease-free survival in @entity1 with subdiaphragmatic Stage I _ II @entity978 . METHODS AND MATERIALS: From September 1962 to April 1995, 109 @entity1 presented at the M. D. Anderson @entity5 Center with subdiaphragmatic @entity978 . The medical records of these @entity1 were retrospectively reviewed; 22 @entity1 who received no treatment at the M. D. Anderson @entity5 Center or who had radiation therapy at other institutions were excluded. The remaining 87 @entity1 formed the basis of this study. The median age of our group was 33 years with a male: female ratio of 3.3:1. The histological subtypes were @entity4383 in 21 (24.1%) @entity1 , mixed cellularity in 31 (35.6%), lymphocyte predominance in 33 (37.9%), lymphocyte depletion in 1 (1.1%) and unclassified histology in 1 (1.1%). Of the @entity1 , 32 (36.8%) underwent laparotomy for diagnosis or staging purpose, 74 (85.1%) had lymphangiography, and 35 (40.2%) had computerized tomography of the abdomen and pelvis. Among the @entity1 , 22 (25%) had more than three sites of nodal involvement at presentation, 56 (64.4%) had pelvic or abdominal disease, and 14 (18.4%) had bulky disease that was defined as disease with the largest dimension > or = 7 cm. Stage distribution was IA in 33.3%, IIA in 39.1%, and IIB in 27.6%. Treatment was radiotherapy alone in 60 (69%) @entity1 , chemotherapy and radiation in 23 (26.4%), and chemotherapy alone in 4 (4.6%). RESULTS: The 10- and 20-year actuarial overall survival rates for all @entity1 were 74.6% and 55.3%, and the corresponding disease-free survival rates were 72.4% and 67.5%, respectively. On univariate analysis, age > 40 years, B symptoms, @entity4383 or mixed cellularity histology, and decreased albumin or hemoglobin levels were statistically significant adverse pretreatment factors for overall survival. B symptoms, decreased albumin level, more than 3 sites of disease at presentation, and Stage II were statistically significant negative pretreatment prognostic factors for disease-free survival. Only B symptoms and decreased albumin level predicted worse outcome in both overall and disease-free survivals. On multivariate analysis, age > 40 years, @entity4383 and mixed cellularity histology, and decreased hemoglobin levels were three independent risk factors for overall survival. An analysis of the pattern of failure revealed that the majority of the @entity1 with central @entity34 who did not receive mantle radiation failed in the supradiaphragmatic area. Late complications of radiation were infrequent. CONCLUSIONS: Long-term follow-up of this group of @entity1 revealed similar overall and disease-free long-term survival, as would be expected from supradiaphragmatic @entity978 . For @entity1 with central @entity34 , it is anticipated that supradiaphragmatic radiation therapy would improve the disease-free survival.

Subdiaphragmatic stage I _ II XXXX : long-term follow-up and prognostic factors.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer'] @entity4383 :: ('MESH:D020518', 'Disease') :: ['nodular sclerosis'] @entity978 :: ('MESH:D006689', 'Disease') :: ["Hodgkin's disease"] @entity34 :: ('MESH:D016609', 'Disease') :: ['Stage II disease']
@entity978 :: (MESH:D006689,Disease) :: ['Hodgkin's disease']
