Clinical features and response to treatment of infradiaphragmatic Hodgkin's disease

Among 247 patients with Hodgkin's disease, initial disease presentation was restricted to infradiaphragmatic sites in 17 (6.9%). Advanced age, B symptoms, increased ESR, low lymphocyte and platelet counts, as well as advanced pathological stage and lymphocyte depletion histology were common presenting features of these patients. 7 patients with infradiaphragmatic disease had isolated involvement of inguinofemoral nodes ("peripheral" group) and 10 had only intraabdominal disease ("central" group). Clinical characteristics of patients with "central" forms were different from those with supradiaphragmatic disease, but no differences were observed between "peripheral" infradiaphragmatic and supradiaphragmatic groups. Complete remission was achieved in the 82.2% of patients with infradiaphragmatic disease. Overall survival was 68% at 5 years, and disease-free survival was 74%. No statistically significant differences were observed in complete remission rates, survival, and disease-free survival when supradiaphragmatic, "central" infradiaphragmatic and "peripheral" infradiaphragmatic forms were compared.