Laparotomy-staged IA versus IIA XXXX . A comparative study with evaluation of prognostic factors for stage IIA disease.

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Ninety-one laparotomy-staged (LAP) IA and IIA @entity978 ( @entity978 ) @entity1 were analyzed to evaluate the prognostic significance of stage, mediastinal status, extranodal disease and histology. Forty IA @entity1 were treated with radiotherapy (XRT) only; of 51 IIA @entity1 , 44 received XRT only and 7 had additional chemotherapy. Disease-free survival (DFS) at 5 and 10 years was 81% and 70%, respectively, with overall survival (S) of 93% and 86%, respectively. Disease-free survival for IA @entity1 (93% at 5 and 10 years) was significantly superior to IIA (73% at 5 years, 52% at 10 years). Survival differences were not statistically significant. For IIA @entity1 receiving XRT only, large @entity3629 was an adverse factor for DFS. Small @entity3629 in IIA was significantly better than no @entity3629 . For the whole group of LAP IA and IIA treated by XRT only, three prognostic groups were identified: (1) Stage IA and Stage IIA with @entity3629 , but less than 7.5 cm in width was highly favorable with less than 10% relapse; (2) Stage IIA nonmediastinal had an intermediate prognosis with relapse in about 33%; (3) Stage IIA large mediastinal (greater than or equal to 7.5 cm) had an unfavorable DFS with relapse in about 55%. The third group contained a highly unfavorable subset with mediastinal masses greater than 10 cm, all of whom relapsed. Salvage therapy was successful in 60% of relapsing @entity1 . In the context of relatively effective salvage therapy, the role of adjuvant chemotherapy in adverse prognostic groups is discussed and it is concluded that the only clearly justifiable use for adjuvant chemotherapy is in @entity1 with massive (greater than 10 cm) mediastinal adenopathy.
