Clinical versus pathologic stage I and II Hodgkin's disease

During an 11-year period, 76 patients with pathologic stage (PS) and 69 with clinical stage (CS) I and II Hodgkin's disease were irradiated. The PS and CS patients were comparable by sex, age, stage, and histopathologic types. Treatment group 1 received a mantle of I and II A lymphocyte predominant and nodular sclerosis plus paraaortic for I-II A mixed cellular and lymphocyte-depleted or B symptoms; group 2 received mantle plus paraaortic for I-II A lymphocyte predominant and nodular sclerosis, and total nodal irradiation for the unfavorable group. The disease-free survival is 47% for the PS and 64% for CS patients in group 1. For group 2, 85% of PS and 83% of CS patients are disease free. Analysis of infradiaphragmatic failures fails to show any advantage for PS over CS. Laparotomy does not obviate infradiaphragmatic irradiation for stage I and II Hodgkin's disease.