State I nodal non-Hodgkin's lymphoma in the neck region: treatment and prognosis

Objective: To evaluate the treatment results and prognostic factors of stage I nodal non-Hodgkin's lymphoma in the neck region. Methods: Eighty-five patients with stage I nodal NHL in the neck region were treated from January 1987 to December 1997. There were 59 males and 26 females. The tumor diameter was <5 cm in 39 and ≥5 cm in 46 patients. Working Formulation was used in pathologic classification, with 7 low-grade, 64 intermediate, 4 high-grade and 10 unclassified. Patients were treated by radiotherapy alone (R) in 11, radiotherapy plus chemotherapy (R + C) in 19, chemotherapy plus radiotherapy (C + R) in 28, chemotherapy plus radiotherapy plus chemotherapy (C + R + C) in 19 and chemotherapy alone (C) in 8. Kaplan-Meier method and Log-rank test were used in survival analysis. Results: The 5-year accumulated survival rate for the entire group was 80.9%. The 5-year survival rates of patients with low-grade, intermediate, high-grade and unclassified pathology were 100%, 79.6%, 75.0%, and 80.0% (P=0.34), without any significant difference. The 5-year survival rates of patients treated with the different methods were: R 81.8%, R + C 73.3%, C + R 78.6%, C + R + C 82.1% and C 100% (P=0.94), also with no significant difference. For patients with tumor diameter < 5 cm and ≥5 cm, the 5-year survival rates were 92.1% and 71.4% (P=0.02), with the difference significant. The 5-year survival rate was significantly improved in patients who had achieved CR following the primary treatment than those in whom only PR was achieved (85.8% vs 65.5%, P<0.01). Conclusions: The treatment results of patients with stage I nodal NHL in the neck region was satisfactory, with the 5-year survival rate reaching 81.0%. Age, pathologic classification, and treatment modality are not significant prognostic factors, while tumor size, involved site, primary treatment response are significant prognostic factors