Prognostic factors in Hodgkin's disease with special reference to age

Abstract

A series of 182 patients with Hodgkin's disease, diagnosed between January 1973 and December 1978 was used to identify prognostic factors with special reference to age. There were 118 men and 64 women (mean age, 47 years; r = 15-92). During the same period 57 elderly patients who were never referred, were reported to the Local Cancer Registry. The diagnosis had been established shortly before death or at autopsy. The 182 patients under study were evenly distributed in Stages I-IV. Nodular sclerosis (38%) and mixed cellularity (38%) were the most common histologic subtypes. The 5-year survival probability estimate was 28% in patients above 50 years as compared to 74% in the remainder. Survival was significantly better in patients with Stage I-II disease and lymphocyte predominance/nodular sclerosis histopathology. Age was the main prognostic factor in the whole series as well as in patients older than 50 years. However, in young patients advanced clinical stage and B-symptoms were related to a poor prognosis. Biologic indicators such as ESR, hemoglobin and albumin were intimately linked to the extent of disease and did not add prognostic information besides that given by the clinical stage. It is concluded that the prognosis in elderly remains poor and appears to be partly unrelated to those factors which determine the prognosis in the young, assumingly reflecting a depressed host-response and/or a decreased tolerance to intensive treatment.