Histopathologic grading of nodular sclerosis Hodgkin's disease. Lack of prognostic significance in 254 surgically staged patients.
BACKGROUND
The cellular composition of nodular sclerosis Hodgkin's disease (NS-HD) varies greatly from patient to patient. It is unclear whether subclassifying NS-HD based on cellular composition has prognostic value, because reported studies examining this issue have shown conflicting results.


METHODS
The initial pathology slides of 254 surgically staged patients with NS-HD treated at the Joint Center for Radiation Therapy were reviewed and subclassified according to British National Lymphoma Investigation criteria. The median follow-up time was 123 months.


RESULTS
A total of 211 patients were classified NS I histology (83%), and 43 patients were classified NS II (17%). There were no differences in the distribution of NS I/NS II patients by age, number of sites of disease, B symptoms, or extent of mediastinal disease. Patients with NS II disease were more likely to be male (P = 0.001), and to have pathologic Stage I-II disease (P = 0.07). The 15-year actuarial rates of disease-free survival were 77 and 80% for NS I and NS II patients, respectively (P = not significant). The 15-year overall survival rates were 87 and 93% for NS I and NS II, respectively (P = not significant). No differences were seen between NS I and NS II patients for overall or disease free survival when analyzed separately by pathologic stage or by initial treatment. Similarly, no differences between NS I and NS II patients were seen in the large subgroup of 155 pathologic stage IA-IIA patients treated with radiation therapy alone. When other histologic parameters were analyzed separately, no differences were seen in the frequency of relapse between the groups based on extent of necrosis, atypia, fibrosis, variant atypia, variant syncytia, eosinophilia, or number of mitoses.


CONCLUSIONS
The histologic subclassification of Hodgkin's disease had no prognostic significance in this group of surgically staged, uniformly treated patients.
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
J L
JL
Hess
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S
Bodis
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Pinkus
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B
Silver
P
P
Mauch
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000401:mortality* / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D016539:Reed-Sternberg Cells / Q000473:pathology; D012598:Sclerosis / Q000473:pathology; D015996:Survival Rate