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Prognosis of non-Hodgkin's lymphomas with special emphasis on the staging classification

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Zeitschrift für Krebsforschung und Klinische Onkologie Aims and scope Submit manuscript

Summary

The prognosis of the non-Hodgkin's lymphomas is determined by

  1. 1.

    the pattern of origin and spread which can be demonstrated in a staging classification,

  2. 2.

    the histopathological type, and

  3. 3.

    the effectiveness and scope of the treatment methods, particularly radio- and chemotherapy.

In the following paper the Ann Arbor Classification, which was originally conceived of for both disease groups (Hodgkin's and non-Hodgkin's lymphomas), is discussed particularly with respect to the applicability and prognostic evaluation for the non-Hodgkin's lymphomas.

The Ann Arbor Classification may in essence reflect the oncological characteristics of the non-Hodgkin's accurately; there are, however, a number of findings with qualitative and quantitative differences which defy integration into the Ann Arbor Classification.

The qualitative differences consist of the differing lymphatic and extralymphatic origins and their consequence for spread and prognosis. The quantitative differences refer to the varying patterns of distribution of the different stages of spreading, whereby the dissemination stages in the non-Hodgkin's lymphomas are more dependent on the histological form than is the case with the Hodgkin's lymphomas, and thus must play a greater role in the prognostic evaluation and indication for treatment. Suggestions have been made for a modification of the Ann Arbor Staging Classification for the non-Hodgkin's lymphomas.

Zusammenfassung

Die Prognose der non-Hodgkin Lymphome wird bestimmt

  1. 1.

    von dem Entstehungs- und Ausbreitungsmuster, das in einer Stadieneinteilung zum Ausdruck gebracht werden kann,

  2. 2.

    vom histopathologischen Typ und

  3. 3.

    von der Wirksamkeit und dem Anwendungsbereich der Behandlungsmethoden, insbesondere der Radio- und Chemotherapie.

Die vorliegende Arbeit befaßt sich insbesondere mit der Gültigkeit der für beide Krankheitsgruppen (Hodgkin- und non-Hodgkin Lymphome) konzipierten Ann Arbor Classification der non-Hodgkin Lymphome, insbesondere für die Möglichkeiten ihrer Anwendbarkeit und prognostischen Beurteilung.

Die Ann Arbor Classification vermag die onkologische Charakteristik der non-Hodgkin Lymphome grundsätzlich richtig wiederzugeben, es gibt aber eine Reihe von Befunden, die nicht ohne weiteres in der Ann Arbor Classification einzuordnen sind. Bei diesen sind qualitative und quantitative Unterschiede zu unterscheiden.

Die qualitativen Unterschiede sind die unterschiedliche lymphatische und extralymphatische Entstehung und ihre Folgen für die Ausbreitung und Prognose. Die quantitativen Unterschiede sind die unterschiedliche Verteilung auf die verschiedenen Ausbreitungsstadien mit stärkerer Bevorzugung der Disseminationsstadien bei den non-Hodgkin Lymphomen. Die Abhängigkeit der Prognose und Therapie ist bei den non-Hodgkin Lymphomen in stärkerem Maße von der histologisohen Form als bei den Hodgkin-Lymphomen abhängig, so daß sie stärker in die prognostische Beurteilung und Behandlungsindikation einbezogen werden muß. Es werden Vorschläge für eine Modifikation der Ann Arbor Stadieneinteilung für die non-Hodgkin Lymphome gemacht.

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Authors and Affiliations

  1. Department of Radiotherapy, Freiburg University, Federal Republic of Germany

    K. Musshoff & H. Schmidt-Vollmer

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  1. K. Musshoff
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  2. H. Schmidt-Vollmer
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Musshoff, K., Schmidt-Vollmer, H. Prognosis of non-Hodgkin's lymphomas with special emphasis on the staging classification. Z. Krebsforsch. 83, 323–341 (1975). https://doi.org/10.1007/BF00573019

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