Rudders R A, Ross M E, DeLellis R A
Cancer. 1978 Aug;42(2):406-16. doi: 10.1002/1097-0142(197808)42:2<406::aid-cncr2820420205>3.0.co;2-h.
The cumulative 10 year lymphoma experience of a teaching hospital and two of its affiliated institutions was reviewed. From this group, a series of 39 cases of regionally localized primary extranodal lymphomas (Ann Arbor Stages IE and IIE) were selected for study. This group of patients was analyzed for response to initial curative treatment and factors influencing prognosis. The disease-free survival rate following initial treatment is 41% and the rate is 51% if those treated for a single relapse are included. Factors which clearly influence prognosis in this group are stage (extent of disease) at presentation and Rappaport histologic subclassification. The relationships of anatomic site and age to prognosis independent of other factors are unclear. There appears to be an association between sites of involvement in Waldeyer's Ring and the gastrointestinal tract seen both initially and in sites of relapse. An analysis of relapse patterns revealed that 33% of relapses occur as solitary extranodal "skip" recurrences that when treated with radical local treatment may result in long disease-free survival. The latter is one of several findings which suggest that a modification of the current Ann Arbor staging system may be necessary to encompass certain unique features of this group of tumors.
回顾了一家教学医院及其两家附属医院10年的淋巴瘤累积病例。从该组病例中，选取了39例区域局限性原发性结外淋巴瘤（Ann Arbor分期IE和IIE期）进行研究。对该组患者进行了初始根治性治疗反应及影响预后因素的分析。初始治疗后的无病生存率为41%，若将单次复发后接受治疗的患者纳入，则该率为51%。在该组中，明显影响预后的因素是就诊时的分期（疾病范围）和Rappaport组织学亚分类。解剖部位和年龄与独立于其他因素的预后之间的关系尚不清楚。在初始发病及复发部位，Waldeyer环和胃肠道的受累部位之间似乎存在关联。复发模式分析显示，33%的复发表现为孤立性结外“跳跃”复发，采用根治性局部治疗可能会带来较长的无病生存期。后者是多项研究结果之一，提示可能有必要对当前的Ann Arbor分期系统进行修订，以涵盖这类肿瘤的某些独特特征。
