Management with chemotherapy only of stage I and II malignant lymphoma of aggressive histologic types

Thirty patients with clinical stage I-II malignant lymphoma of aggressive histologic types (histiocytic, undifferentiated, and mixed) were treated with chemotherapy alone. Of 25 patients with measurable disease, 22 (88%) achieved a complete remission. The remaining five patients had been rendered disease-free at the time of excisional biopsy; for this reason, they are considered evaluable only for duration of disease-free survival. Of the 27 patients who achieved disease-free status, 23 (85%) remain free of any evidence of disease. All eight patients with stage I disease and 15 of the 19 patients with stage II disease remain free of disease. The use of clinical instead of surgical staging, followed promptly by systemic treatment with combination chemotherapy, results in a substantial cure rate and avoids the undesirable morbidity and treatment delay associated with laparotomy. The results of this approach compare favorably with those obtained by radiotherapy alone or with combined radiation and chemotherapy for surgically staged patients.