Prognosis

Outlook

Using 2014-2020 data, the National Cancer Institute Surveillance, Epidemiology, and End Results Program reports a 5-year relative survival rate of 88.9% among patients with any stage of HL at diagnosis.[153]

Early HL (stage I to stage II)

The prognosis for patients with early-stage HL is excellent with long-term disease control of 80% to 90% following combined-modality therapy (i.e., combination chemotherapy followed by low-dose involved-field radiation therapy [IFRT]).[51][55][154]

While recurrent HL is the leading cause of death for the first 15 years after treatment, with continued follow-up patients are more likely to die of secondary malignancies or cardiac disease.[155]

Newer treatment approaches aim to reduce the intensity of treatment yet maintain high cure rates. These include the use of involved-site radiation therapy (ISRT) instead of IFRT. ISRT focuses radiation only on involved lymph nodes and nearby sites, minimizing radiation exposure to uninvolved structures and reducing the risk of adverse effects (e.g., secondary malignancies, cardiovascular disease, decreased pulmonary function). Although the evidence for ISRT in HL is evolving, it is the preferred approach and current standard of care.[33]​[70][71][72][73]

Advanced HL (stage III to stage IV)

Advanced HL is a heterogeneous disease. Overall, the long-term disease control after chemotherapy alone or combined-modality therapy is approximately 60% to 80%.[156][157][158]​ 

Nodular lymphocyte-predominant HL (NLPHL)

Most patients with NLPHL present with asymptomatic early (stage I to II) disease. Overall prognosis for patients with NLPHL is good, particularly for early-stage disease. Long-term disease control with current treatment strategies is approximately 80% to 90% for early-stage disease.[132][159][160][161]

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