Significance of epitrochlear lymph node involvement in Hodgkin disease

Area of Science:

• Oncology
• Radiation Oncology
• Hematology

Background:

• Epitrochlear lymph node involvement in Hodgkin disease (HD) is an uncommon clinical presentation.
• Limited data exists regarding the specific treatment and long-term outcomes for this rare manifestation of HD.

Purpose of the Study:

• To describe the clinical characteristics, histopathology, and treatment of patients with epitrochlear lymphadenopathy due to Hodgkin disease.
• To evaluate the treatment efficacy and long-term survival outcomes for this rare HD presentation.

Main Methods:

• Retrospective analysis of 17 Hodgkin disease patients with epitrochlear involvement treated between 1968 and 1997.
• Patients received radiation therapy using single-field or separate-field techniques, with a median dose of 3600 centigrays to the epitrochlear region.
• Survival outcomes were calculated using the Kaplan-Meier method with a median follow-up of 17 years.

Main Results:

• The 15-year actuarial rates for freedom from recurrence, cause-specific survival, and overall survival were 70%, 88%, and 70%, respectively.
• Patients with epitrochlear involvement (clinical stage IA-IIB) had a 15-year overall survival rate of 90%, compared to 80% for those without epitrochlear involvement.
• No recurrences involved the epitrochlear or ipsilateral brachial region, and no complications from radiation therapy were observed.

Conclusions:

• Radiation therapy techniques, including single-field and separate-field methods, are feasible and effective for treating Hodgkin disease with epitrochlear involvement.
• The prognosis for patients with this rare epitrochlear presentation of Hodgkin disease appears comparable to that of patients with more common presentations when treated appropriately.