A multivariate analysis of prognostic factors in adult Hodgkin's disease.

A multivariate analysis of the prognostic factors was carried out with a Cox model on 167 patients with Stage I-IV Hodgkin's disease. The following indicators were prospectively registered: Sex, age, clinical stage, systemic symptoms, histological type, number of involved areas, nodal size, mediastinal thoracic ratio (MTR), localization of mediastinal involvement according to the aortic arcus, hilar involvement, extent of radiotherapy, and extent and mode of chemotherapy. A linear logistic analysis showed that most of the indicators were interrelated. This emphasizes the necessity of a multivariate analysis in order to assess the independent influence of each of them. The three main prognostic indicators for complete remission achievement were age, clinical stage and involvement of lung hili. The three main prognostic indicators for disease-free survival were sex, size of mediastinal involvement (MTR) and use of alternating chemotherapy COPP/ABVD in the initial treatment strategy. The most important prognostic factor for survival was clinical stage followed by hilar involvement, age, and nodal size. The coefficients estimated by Cox regression analysis can be used to combine the important prognostic factors into a single index for each patient at presentation. The prognostic index for each patient would allow the identification of cases with poor prognosis who might benefit from additional initial treatment.