Fuller L M, Madoc-Jones H, Gamble J F, Butler J J, Sullivan M P, Fernandez C H, Gehan E A
Cancer. 1977 May;39(5):2174-82. doi: 10.1002/1097-0142(197705)39:5<2174::aid-cncr2820390534>3.0.co;2-8.
This paper describes preliminary radiotherapy results in 90 patients with Stage I and II Hodgkin's disease who were evaluated by laparotomy, including splenectomy, and liver and bone marrow biopsies. As a result of selection by laparotomy, the estimated five-year survival rate for these patients was 96%. No statistically significant differences were detected in the disease-free survival for patients with mixed cellularity, nodular sclerosis, and lymphocytic predominance disease. Since only one patient with lymphocytic depletion was in this series, no statement can be made regarding this rare histopathology. Patterns of new disease differed for Stage I and II patients. The major difference was that patients with nodular sclerosing Stage II presentations involving the mediastinum were at considerable risk of developing subsequent disease in the pulmonary parenchyma or the pleura. This finding, together with the demonstration that a histologic diagnosis of mixed cellularity did not carry an inferior prognosis, indicates the need for reassessment of the appropriateness of applying treatment programs based on results of lymphangiographically staged patients to Stage I and II patients evaluated by laparotomy.
本文描述了90例接受剖腹探查（包括脾切除术）以及肝脏和骨髓活检评估的Ⅰ期和Ⅱ期霍奇金病患者的初步放疗结果。经剖腹探查筛选，这些患者的预计五年生存率为96%。混合细胞型、结节硬化型和淋巴细胞为主型疾病患者的无病生存率未检测到统计学显著差异。由于本系列中仅有1例淋巴细胞消减型患者，因此无法对这种罕见的组织病理学类型作出评价。Ⅰ期和Ⅱ期患者的新发病模式有所不同。主要差异在于，结节硬化型Ⅱ期累及纵隔的患者发生肺实质或胸膜后续疾病的风险相当高。这一发现，连同混合细胞型组织学诊断预后并不较差的证明，表明有必要重新评估将基于淋巴管造影分期患者结果的治疗方案应用于经剖腹探查评估的Ⅰ期和Ⅱ期患者的适宜性。
