XXXX in Costa Rica: twelve years' experience of primary treatment by chemotherapy alone, without staging laparotomy.

@entity1 @entity4174 @entity3480 @entity229 @entity1259 @entity786 @entity1891 @entity1732 @entity978 @entity5713
This is a prospective and nonrandomized study in which 86 @entity1 with previously untreated @entity978 ( @entity978 ) were clinically staged (CS) and treated with chemotherapy (CT) alone. Fifty-two (CS IA-38, IIA-7, IIB-3, IIIA-4) received six courses of @entity786 , @entity5713 , @entity4174 , and @entity229 (CVPP). Ten (CS IA with peripheral nodes) received only three courses of CVPP with a reinforcement of C on day 8. Twenty-four (CS IIIB-18, @entity3480 , IVB-4) received six courses of CVPP alternating with six courses of @entity1259 , @entity1732 , and @entity1891 (EBO). Surgical staging was not performed in any @entity1 . Two @entity1 (CS IIIB) had partial remission and died from progressive disease. Seventy out of 86 @entity1 have not relapsed and are in complete remission with a median follow-up of 65 months (range 13-156 months); 14 @entity1 relapsed seven to 37 months from diagnosis (median 16 months); one of them (IV B) died of disease. Thirteen are in second and third remission (median 55 months). Actuarial five year survival rates and relapse-free survival rates are 100% and 90% for CS I to IIIA and 81% and 60% for CS IIIB and IV, respectively. As a result of this study, we can conclude that in developing countries most of the @entity1 with @entity978 staged by noninvasive diagnostic techniques can be cured with CT alone as primary treatment and thus will not suffer from the late effects of radiotherapy (RT) and the morbidity of laparotomy and splenectomy. RT alone or with other CT combinations should be considered for @entity1 who develop relapse of @entity978 .
