ISSN:
1569-8041
Keywords:
disease free survival
;
early stage Hodgkin's disease
;
prognostic factor
;
prognostic index
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background:The seven-factor International Prognostic Score (IPS)has been developed and verified for patients with advanced stage Hodgkin'sdisease (HD). This report aims to assess the predictive power of the IPS forearly stage HD patients. Patients and methods:Data on patient characteristics, therapy andfollow-up were available for 1424 adult patients in clinical stagesI–IIIA treated for primary HD in two German Hodgkin's Lymphoma StudyGroup (GHSG) trials (1988–1994). Patients with risk factors or in stageIIIA received chemo–radiotherapy (CMT; trial HD5); others receivedextended field radiotherapy (RT) alone (HD4). The IPS could be calculated for712 HD5 and 249 HD4 patients (70%). The prognostic value of the IPS andits component factors was assessed using Cox proportional hazards regression.A search was made for additional factors which could add predictive power tothe IPS. Results:The IPS identified 40% of the unfavourable earlystage patients with an 8% lower disease-free survival at six years(hazard ratio 1.66, P = 0.0018). The factor ‘low albumin’ was theonly score component giving a significant individual contribution. Allowingfor the IPS, extranodal involvement, particularly in stages IIB–IIIA,was associated with worse prognosis, but no further significantly prognosticfactors were revealed. The IPS identified a similar hazard ratio in HD4,although here the effect was not significant. Conclusions:The IPS for advanced HD has modest predictive abilityin unfavourable early stage patients. Modification of the IPS for use withearly stages may improve its prognostic power.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008325627670
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