Hodgkin's disease in Denmark. A national clinical study by the Danish Hodgkin Study Group, LYGRA

Abstract

During the last 8 years (1971-1979) all newly diagnosed previously untreated patients with Hodgkin's disease in Denmark have been centralized to uniform staging procedures and treatment. A total of 802 patients were registered, or 2 patients/100 000. Lymphangiography was performed in 708 patients (88%), and 437 patients (55%) underwent laparotomy with splenectomy. Treatment included radiotherapy, combination chemotherapy (MOPP or similar programmes), and combined modality treatment. The overall 8-year actuarial survival for all stages combined was 66%, and relapse-free survival was 55%. 144 patients died of Hodgkin's disease, 23 from complications to therapy and examination procedures, and 54 died of unrelated causes. Survival was significantly better for patients without B-symptoms, and decreased gradually with advancing age. There was a strong correlation between unfavourable prognosis and advancing stage and/or histology, but mediastinal involvement had no influence upon the prognosis. Staging laparotomy was associated with 4 deaths due to infection, and splenectomy with 10 cases of severe pneumococcal infections, 4 of which were fatal. Fatal complications due to subsequent treatment included 2 cases of cardiac arrest following mantle-field irradiation and 3 cases of haemorrhage or sepsis following chemotherapy. 5 cases of acute myeloid leukaemia were observed.