[Late recurrences in Hodgkin's disease following radiotherapy]

1. From 1950 to 1970, 92 patients with Hodgkin's disease stage I and II were treated by irradiation at the Universitäts-Strahlenklinik Marburg. Staging was performed without diagnostic laparotomy. More than a third might be staged wrong. 2. The over-all survival rates for both, stage I and II, are 65% after five years, 40% after ten years. 15% of the patients are expected to be cured. 3. Three late recurrences after 12 or 13 years are contradictory to the definition of cure in Hodgkin's disease, as a ten years lasting relapse-free interval after primary treatment. In two further cases lymphogranulomatosis developed 7 and 12 years after operation and irradiation of mediastinal tumors, which were histologically classified as lymphadenitis and polymorphcellular sarcoma, but here and there showed the features of lymphogranulomatosis. Two further cases of lymphogranulomatosis were seen with extraordinary long remissions of 11 and 17 years. 4. On the understanding that the primary tumor disease had been cured, we can look at the recurrences as at second tumor disease. Then a tumor-disposition in these patients must be discussed. 5. The occurrence of the prognostically advantageous histologic type of nodular sclerosis, the age of the patients between 27 and 37 years at the first manifestation of the disorder, and the tolerance of peripheral localisation of the tumor disease lead to the conclusion that histologic type and course show the ratio between tumor disease and immunologic situation of the patient. Probably, the histologic features might be the expression of this situation.