Lymphoma - Hodgkin: Stages - Cancer.Net

A mediastinal lymph node mass, located in the center of the chest, that is larger than 10 cm is associated with a poorer prognosis. Small mediastinal masses are ... SkiptoContent Español Search Menu YouarehereHome>TypesofCancer>Lymphoma-Hodgkin>Lymphoma-Hodgkin:Stages RequestPermissions Lymphoma-Hodgkin:Stages ApprovedbytheCancer.NetEditorialBoard,07/2020 ONTHISPAGE:Youwilllearnabouthowdoctorsdescribetheextentofacancer’sgrowthorspread.Thisiscalledthestage.Youwillalsodiscoverwhatprognosticfactorshelpdoctorspredicthowwelltreatmentwillwork.Usethemenutoseeotherpages. StaginghelpstodescribewheretheHodgkinlymphomaislocated,iforwhereithasspread,andwhetheritisaffectingotherpartsofthebody. Doctorsusediagnosticteststofindoutthecancer’sstage,sostagingmaynotbecompleteuntilalltestsarefinished.Knowingthestagehelpsthedoctortodecidewhatkindoftreatmentisbestandcanhelppredictapatient’sprognosis,whichisthechanceofrecovery.Therearedifferentstagedescriptionsfordifferenttypesofcancer. WhenstagingHodgkinlymphoma,doctorsevaluatethefollowing: Thenumberofcancerouslymphnodeareas. Whetherthecancerouslymphnodesarelocalizedorgeneralized.Localizedmeanstheyarelocatedonlyin1areaofthebody.Generalizedmeanstheyareinmanyareasofthebody. Whetherthecancerouslymphnodesareon1orbothsidesofthediaphragm,thethinmuscleunderthelungsandheartthatseparatesthechestfromtheabdomen. Whetherthediseasehasspreadtothebonemarrow,spleen,orextralymphaticorgans(organsoutsidethelymphaticsystem;notedusingan“E”below),suchastheliver,lungs,orbone. Lymphomastagegroupings ThestageofHodgkinlymphomadescribestheextentofthespreadofthetumor,usingtheterms"stageI"to"stageIV"(1through4).AsexplainedinSymptomsandSigns,eachstagemayalsobefurtherdividedinto“A”and“B”categories,basedonwhetherornotthepersonisexperiencingspecificsymptoms. StageI:Thelymphomaisfoundin1lymphnoderegion.Or,thelymphomahasinvaded1extralymphaticorganorsite(identifiedusingtheletter“E”)butnotanylymphnoderegions(stageIE);thisisrareinHodgkinlymphoma. StageII:Anyofthefollowingconditionsapplies: StageII:Thelymphomaisin2ormorelymphnoderegionsonthesamesideofthediaphragm. StageIIE:Thelymphomainvolves1organanditsregionallymphnodes(lymphnodeslocatednearthesiteofthelymphoma),withorwithoutlymphomainotherlymphnoderegionsonthesamesideofthediaphragm. StageIIbulky:EitherstageIIorstageIIEapplies,plusthereisamassinthechest.Themassiseitherlargerthanone-thirdthediameterofthechestorlargerthan10centimeters(cm).Acentimeterisroughlyequaltothewidthofastandardpenorpencil. StageIII:Thereislymphomainlymphnodeareasonbothsidesofthediaphragm,meaningaboveandbelowit. StageIV:Thelymphomahasspreadto1ormoreorgansbeyondthelymphnodes.Hodgkinlymphomausuallyspreadstotheliver,bonemarrow,orlungs. Recurrent:Recurrentlymphomaislymphomathathascomebackaftertreatment.Lymphomamayreturnintheareawhereitfirststartedorinanotherpartofthebody.Recurrencemayoccuratanytime,includingshortlyafterthefirsttreatmentoryearslater.Ifthelymphomadoesreturn,therewillbeanotherroundofteststolearnabouttheextentoftherecurrence.Thesetestsandscansareoftensimilartothosedoneatthetimeoftheoriginaldiagnosis. Prognosticfactors Inadditiontostage,doctorsuseotherprognosticfactorstohelpplanthebesttreatmentandpredicthowwellthistreatmentwillwork.ForpeoplewithHodgkinlymphoma,severalfactorscanpredictwhetherthediseasewillreturnandwhichtreatmentswillbesuccessful.Thelymphomamaybedescribedas"high-riskdisease"or"low-riskdisease"basedonhowmanyofthefollowingprognosticfactorsthereare. Factorsthatareconsideredlessfavorableandleadtoapoorerprognosisinclude: Beingmale. Age45andolder. Lowbloodalbumin(atypeofprotein)levels,definedaslessthan4g/L. Lowhemoglobin(redbloodcellcount),definedaslessthan10.5g/dL. Whitebloodcellcountthatismorethan15,000percubicmillimeter(mm3). Lymphocytecountthatislessthan600permm3,lessthan8%ofthetotalwhitebloodcellcount,orboth. StageIVdisease. Otherprognosticfactorsthatareconsidered,especiallyforearly-stageHodgkinlymphoma,include: Ahighererythrocytesedimentationrate,orESR(see"Laboratorytests"inDiagnosis),isassociatedwithapoorerprognosis. Peoplewithlymphocyte-predominantHodgkinlymphoma,nodularsclerosisHodgkinlymphoma,andlymphocyte-richclassicHodgkinlymphomahaveabetterprognosis,comparedwithothertypesofHodgkinlymphoma. Amediastinallymphnodemass,locatedinthecenterofthechest,thatislargerthan10cmisassociatedwithapoorerprognosis.Smallmediastinalmassesarenotassociatedwithapoorerprognosis. Havingahighnumberofinvolvedlymphnodesitesisassociatedwithapoorerprognosis. UsedwithpermissionoftheAmericanCollegeofSurgeons,Chicago,Illinois.TheoriginalandprimarysourceforthisinformationistheAJCCCancerStagingManual,EighthEdition(2017),publishedbySpringerInternationalPublishing. Informationaboutthelymphoma’sstagewillhelpthedoctorrecommendaspecifictreatmentplan.The nextsectioninthisguideisTypesofTreatment. Usethemenutochooseadifferentsectiontoreadinthisguide. ‹Lymphoma-Hodgkin-Diagnosis up Lymphoma-Hodgkin-TypesofTreatment› f t k e P Lymphoma-HodgkinGuide Cancer.NetGuideLymphoma-Hodgkin Introduction Statistics MedicalIllustrations RiskFactors SymptomsandSigns Diagnosis Stages TypesofTreatment AboutClinicalTrials LatestResearch CopingwithTreatment LateEffectsofTreatment Follow-UpCare Survivorship QuestionstoAsktheHealthCareTeam AdditionalResources ViewAllPages Othertypesofcancer AdenoidCysticCarcinoma AdrenalGlandTumor Amyloidosis AnalCancer AppendixCancer Astrocytoma-Childhood Ataxia-Telangiectasia Beckwith-WiedemannSyndrome BileDuctCancer(Cholangiocarcinoma) Birt-Hogg-DubéSyndrome BladderCancer BoneCancer(SarcomaofBone) BrainStemGlioma-Childhood BrainTumor BreastCancer BreastCancer-Inflammatory BreastCancer-Metastatic BreastCancer,Male CarneyComplex CentralNervousSystemTumors(BrainandSpinalCord)-Childhood CervicalCancer ChildhoodCancer ColorectalCancer CowdenSyndrome Craniopharyngioma-Childhood DesmoidTumor DesmoplasticInfantileGanglioglioma,ChildhoodTumor Ependymoma-Childhood EsophagealCancer EwingSarcoma-ChildhoodandAdolescence EyeCancer EyelidCancer FamilialAdenomatousPolyposis FamilialGIST FamilialMalignantMelanoma FamilialPancreaticCancer GallbladderCancer GastrointestinalStromalTumor-GIST GermCellTumor-Childhood GestationalTrophoblasticDisease HeadandNeckCancer HereditaryBreastandOvarianCancer HereditaryDiffuseGastricCancer HereditaryLeiomyomatosisandRenalCellCancer HereditaryMixedPolyposisSyndrome HereditaryPancreatitis HereditaryPapillaryRenalCarcinoma HIV/AIDS-RelatedCancer JuvenilePolyposisSyndrome KidneyCancer LacrimalGlandTumor LaryngealandHypopharyngealCancer Leukemia-AcuteLymphoblastic-ALL-Childhood Leukemia-AcuteLymphocytic-ALL Leukemia-AcuteMyeloid-AML Leukemia-AcuteMyeloid-AML-Childhood Leukemia-B-cellProlymphocyticLeukemiaandHairyCellLeukemia Leukemia-ChronicLymphocytic-CLL Leukemia-ChronicMyeloid-CML Leukemia-ChronicT-CellLymphocytic Leukemia-Eosinophilic Li-FraumeniSyndrome LiverCancer LungCancer-Non-SmallCell LungCancer-SmallCell Lymphoma-Hodgkin Lymphoma-Hodgkin-Childhood Lymphoma-Non-Hodgkin Lymphoma-Non-Hodgkin-Childhood LynchSyndrome Mastocytosis Medulloblastoma-Childhood Melanoma Meningioma Mesothelioma MultipleEndocrineNeoplasiaType1 MultipleEndocrineNeoplasiaType2 MultipleMyeloma MUTYH(orMYH)-AssociatedPolyposis MyelodysplasticSyndromes-MDS NasalCavityandParanasalSinusCancer NasopharyngealCancer Neuroblastoma-Childhood NeuroendocrineTumoroftheGastrointestinalTract NeuroendocrineTumoroftheLung NeuroendocrineTumorofthePancreas NeuroendocrineTumors NeurofibromatosisType1 NeurofibromatosisType2 NevoidBasalCellCarcinomaSyndrome OralandOropharyngealCancer Osteosarcoma-ChildhoodandAdolescence Ovarian,FallopianTube,andPeritonealCancer PancreaticCancer ParathyroidCancer PenileCancer Peutz-JeghersSyndrome PheochromocytomaandParaganglioma PituitaryGlandTumor PleuropulmonaryBlastoma-Childhood ProstateCancer Retinoblastoma-Childhood Rhabdomyosarcoma-Childhood SalivaryGlandCancer Sarcoma-Kaposi SarcomasofSpecificOrgans Sarcomas,SoftTissue SkinCancer(Non-Melanoma) SmallBowelCancer StomachCancer TesticularCancer ThymomaandThymicCarcinoma ThyroidCancer TuberousSclerosisComplex UnknownPrimary UterineCancer VaginalCancer VonHippel-LindauSyndrome VulvarCancer WaldenstromMacroglobulinemia(LymphoplasmacyticLymphoma) WernerSyndrome WilmsTumor-Childhood XerodermaPigmentosum Timely.Trusted.Compassionate. 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