Infradiaphragmatic Hodgkin's disease

Between 1968 and 1994, 133 patients with stages I and II supradiaphragmatic Hodgkin's disease were evaluated at our institution. During the same period we treated only 11 patients with stages I and II infradiaphragmatic Hodgkin's disease. When compared to patients with disease above the diaphragm, patients with Hodgkin's disease below the diaphragm were more frequently male (p < 0.05), were generally older (46.3 vs 40.1 years, but the difference was not significant), had a higher incidence of systemic symptoms (p < 0.05), and had predominantly histologic subtypes with mixed cellularity and lymphocyte predominance. Primary treatment included inverted Y radiotherapy in 3 patients, polychemotherapy in 6, and combined treatment in 2. Ten patients achieved complete response. Five- and ten-year survival rates were 90% and 67.5%, respectively. There was no difference in survival rate between patients with infradiaphragmatic and supradiaphragmatic Hodgkin's disease receiving similar treatment.