For incurable lymphoma, they help predict how aggressive the lymphoma might be. Lower overall health, known as performance status (see below)Ĭancer in more than 1 organ or site outside the lymph node regionįor people with follicular lymphoma, doctors consider the hemoglobin level, which is a part of the blood, the number of lymph node groups involved, LDH level, stage, and age.ĭoctors use these factors to estimate the prognosis of a lymphoma. Patients are classified into low-risk or high-risk groups depending on several factors, including:īlood test results showing higher-than-normal levels of lactate dehydrogenase (LDH), an enzyme found in the blood Each type of NHL has specific criteria as a part of the IPI. In addition to stage, a scale called the International Prognostic Index (IPI) is important in determining the prognosis of aggressive lymphomas. The original source for this material is Cheson BD, Fisher RI, Barrington SF, et al.: Recommendations for initial evaluation, staging and response assessment of Hodgkin and non-Hodgkin lymphoma-the Lugano Classification, published in the Journal of Clinical Oncology, Septemvol. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above. Recurrence may occur shortly after the first treatment or years later. It may return in the area where it first started or in another part of the body. Recurrent/relapsed: Recurrent lymphoma is lymphoma that has come back after treatment. Progressive/refractory: If the cancer grows larger or spreads while the patient is being treated for the original lymphoma, it is called progressive disease. Stage III and stage IV are now considered a single category because they have the same treatment and prognosis. Stage III-IV lymphomas are common, still very treatable, and often curable, depending on the NHL subtype. Lymphoma most often spreads to the liver, bone marrow, or lungs. Stage III-IV: There is cancer in lymph node areas on both sides of the diaphragm (stage III), or the cancer has spread throughout the body beyond the lymph nodes (stage IV). The cancer involves 1 organ and its regional lymph nodes, with or without cancer in other lymph node regions on the same side of the diaphragm (stage IIE). The cancer is in 2 or more lymph node regions on the same side of the diaphragm (stage II). The cancer has invaded 1 extralymphatic organ or site (identified using the letter “E”) but not any lymph node regions (stage IE).
The cancer is found in 1 lymph node region (stage I). Stage I: Either of these conditions applies: It is important to remember that even stage IV lymphomas can often be treated successfully. In these situations, the prognostic factors become more important (see “International Prognostic Index” and “Functional status” below). For other subtypes, the disease has often spread throughout the body by the time it is diagnosed. This staging system is helpful for the most common subtypes of lymphoma. The stage of lymphoma describes the extent of spread of the tumor using the Roman numerals I, II, III, or IV (1 through 4).
If the disease has spread to the bone marrow, spleen, or extralymphatic organs (organs that are not part of the lymphatic system), such as the liver, lungs, or brain
If the cancerous lymph nodes are on 1 or both sides of the diaphragm, the thin muscle under the lungs and heart that separates the chest from the abdomen Where the cancerous lymph nodes are: regional (in the same area of the body) or distant (in other parts of the body) How many cancerous lymph node areas there are There are different stage descriptions for different types of cancer. Knowing the stage helps the doctor recommend what kind of treatment is best and can help predict a patient’s prognosis. Staging is a way of describing where NHL is located, if or where it has spread, and whether it is affecting other parts of the body.ĭoctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. ON THIS PAGE: You will learn about how doctors describe lymphoma’s location and spread.
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