A 40·year-old patient has been diagnosed with Hodgkin’s disease. He is being treated with radiotherapy and chemotherapy.
Which one of the following is the most important factor predicting his prognosis?
A Erythrocyte sedimentation rate
8 Gender
c Lymph node sizes
Response to treatment
E Spleen size
Explanation:
The answer is Response to treatment - The response to treatment is the most important factor for predicting this man’s prognosis. In fact, this is usually the case for all malignant processes. A good response to initial treatment will naturally be of good prognosis, whereas refractory disease usually indicates a poor overall prognosis.
Erythrocyte sedimentation rate {ESR) {Option A) is incorrect. The ESR 09. is considered prognostic for early stage Hodgkin’s disease, with a raised ESR being considered a risk factor.
Gender (Option B) is incorrect Gender is considered to be a poor risk factor in advanced Hodgkin’s disease, with being male an adverse prognostic factor.
Lymph node sizes (Option C) is incorrect. The lymph nodes sizes are less prognostic, but a bulky mediastinal mass ts considered a risk factor for prognosis in early stage Hodgkin’s disease. Advanced stage disease (stage IV) is considered prognostic for advanced Hodgkin’s disease.
Spleen size {Option E) is incorrect. Spleen size is not considered prognostic in either early or advanced Hodgkin’s disease.