Extranodal head and neck lymphoma. Prognosis and patterns of recurrence.

Stages I and II extranodal head and neck lymphomas treated between 1969 and 1986 were reviewed to determine prognosis and recurrence patterns. Forty-four patients had low-grade lymphoma, with 57% remaining disease free (median survival, 7.2 years). Radiotherapy provided long-term disease-free survival and palliation in the majority of patients. Relapse did not adversely affect survival. Eighty-eight patients had intermediate- or high-grade lymphoma, with 42% remaining disease free (median survival, 2.4 years). Treatment with radiotherapy alone was inadequate. Combined radiotherapy and anthracycline-containing chemotherapy appeared to be superior. Extranodal sites of first relapse were common. Central nervous system relapse was common with primary tumors located above the pterygopalatine line. Central nervous system staging and prophylactic therapy is warranted in patients with tumors above the pterygopalatine line.