2-[18F]-fluoro-2-desoxy-D-glucose positron emission tomography initial staging impacts on survival in Hodgkin lymphoma

Table 1 Clinical characteristics of 267 patients with newly diagnosed hodgkin lymphoma n (%)

Characteristics	Era 1 150 patients AS	Era 2 117 patients MS	P
Gender
Male	82 (54.7)	63 (52.5)	0.89
Age, median ± SD	33.4 ± 15.1	34.1 ± 16.1	0.25
Pathological subtype
Nodular sclerosis	88 (58.7)	71 (59.2)
Non classified	17 (11.3)	22 (18.3)
Mixed cellularity	31 (20.7)	12 (10.0)	0.53
Lymphocyte predominance	12 (8.0)	9 (7.5)
Lymphocyte depleted	2 (1.3)	6 (5.0)
B symptoms	99 (66.0)	76 (65.0)	0.85
Bulky disease (> 7 cm)	91 (60.3)	67 (57.3)	0.74
Clinical stage			0.12
I	12 (8.0)	9 (7.7)
II	61 (40.7)	45 (38.5)
III	35 (23.3)	27 (23.1)
IV	42 (28.0)	36 (30.8)
Treatment failure	43 (28.7)	36 (30.8)	0.70
Death	20 (13.3)	14 (12.0)	0.73

AS: Anatomical staging; MS: Metabolic staging.

Table 2 Hazard ratio of clinical characteristics in the group of patients staged conventionally and with 2-[18F]-fluoro-2-desoxy-D-glucose positron emission tomography

	Five-year-EFS				Five-year-OS
	AS		MS		CS		MS
	HR (95%CI)	P	HR (95%CI)	P	HR (95%CI)	P	HR (95%CI)	P
Age (> 45, ≤ 45)	1.89 (0.95-3.76)	0.067	1.75 (0.86-3.57)	0.121	2.97 (1.18-7.47)	0.020	6.59 (2.20-19.68)	0.001
Gender	1.32 (0.72-2.44)	0.362	0.85 (0.44-1.63)	0.628	2.00 (0.76-5.20)	0.155	0.83 (0.29-2.38)	0.739
B symptoms	2.19 (1.05-4.57)	0.036	1.76 (0.82-3.76)	0.140	2.27 (0.76-6.81)	0.142	1.44 (0.45-4.61)	0.532
Bulky	0.94 (0.50-1.79)	0.868	0.94 (0.48-1.84)	0.869	1.06 (0.40-2.77)	0.899	0.41 (0.13-1.22)	0.111
Early vs advance clinical stage	2.05 (1.09-3.85)	0.024	2.73 (1.19-6.24)	0.017	2.51 (0.96-6.55)	0.059	8.09 (1.05-61.85)	0.044
Stage IV disease	2.42 (1.32-4.42)	0.004	2.33 (1.20-4.50)	0.012	3.67 (1.52-8.88)	0.004	6.54 (1.82-23.48)	0.004
Serum albumin	1.09 (.057-2.07)	0.775	1.52 (0.71-3.25)	0.273	2.12 (0.71-6.37)	0.178	1.91 (0.53-6.87)	0.318
Hemoglobin	1.50 (0.79-2.85)	0.206	1.35 (0.67-2.71)	0.399	2.47 (1.02-5.96)	0.044	1.43 (0.48-4.29)	0.514
White blood cell count	2.11 (1.03-4.30)	0.039	1.62 (0.62-4.18)	0.319	2.55 (1.84-8.2)	0.041	1.68 (0.37-7.54)	0.495
Lymphocyte count	1.81 (0.95-3.44)	0.067	2.61 (1.27-5.3)	0.009	2.44 (0.99-6.00)	0.050	2.84 (0.95-8.51)	0.061
IPI (0-2, ≥ 3)	3.41 (1.80-6.47)	0.000	2.08 (1.07-4.08)	0.031	3.74 (1.43-9.77)	0.007	4.98 (1.38-17.86)	0.014

IPI: International prognosis index; OS: Overall survival; EFS: Event free survival; AS: Anatomical staging; MS: Metabolic staging; CS: Conventional stage.

Table 3 The three- and five-year overall survival and event free survival of conventional staging and metabolic staging in initial staging of hodgkin lymphoma patients

Survival	150Patients CS	117Patients MS	267Total patients
Three-year EFS
Stage I	91.7%	100.0%	93.7%
Stage II	78.7%	84.4%	80.9%
Early stage	80.7%	85.6%	82.6%
Stage III	79.7%	76.7%	78.4%
Stage IV	63.7%	65.2%	64.5%
Advanced stage	71.0%	70.0%	70.5%
Five-year EFS
Stage I	91.7%	100.0%	93.7%
Stage II	77.0%	84.4%	79.8%
Early stage	79.3%	85.6%	81.5%
Stage III	76.5%	69.0%	73.1%
Stage IV	58.6%	44.8%	53.7%
Advanced stage	66.7%	53.6%	61.9%
Three-year OS
Stage I	91.7%	100.0%	93.7%
Stage II	93.2%	97.2%	94.8%
Early stage	93.0%	97.5%	94.6%
Stage III	94.2%	96.3%	95.2%
Stage IV	77.2%	74.2%	75.7%
Advanced stage	84.9%	82.8%	83.9%
Five-year OS
Stage I	91.7%	100.0%	93.7%
Stage II	91.2%	97.2%	93.3%
Early stage	91.3%	97.5%	93.4%
Stage III	94.2%	90.9%	92.9%
Stage IV	71.1%	74.2%	72.5%
Advanced stage	81.5%	80.7%	81.1%

OS: Overall survival; EFS: Event free survival; CS: Conventional stage; MS: Metabolic staging.