A combined clinical and histological assessment of survival of patients with Hodgkin's disease.

This paper reviews a series of 246 patients with Hodgkin's disease treated in the Royal Air Force Medical Service between 1940 and 1966. The clinical and histological staging of the disease in relation to the survival time is evaluated. The variation in the clinical patterns of the disease, together with the histological appearances in the affected glands, can be related to the patient's defence system. A most important clinical factor in assessing prognosis is considered to be the presence or absence of constitutional symptoms. The majority of the patients who had constitutional symptoms on presentation also had many glands involved. It was found in those patients who had no constitutional symptoms at the onset of the disease that there was little difference in survival time between those with glands involved in a single group or region and those with glands involved in many regions, whether above and/or below the diaphragm. Those patients with histologically well differentiated lesions showed a significantly higher survival rate than those in the histologically poorly differentiated groups.