Skip to content skip to primary navi skip to secondary navi skip to meta navi search

Risk Groups

Apart from histology and tumor spread, precisely defined risk factors play an important role in the trials of GHSG.

These risk factors include:

  • Presence of a large mediastinal mass, measured by means of a chest X‑ray image; the mediastinal mass is considered as large if it measures at least one third of the transverse diameter of the thorax.
  • Extranodal disease, i.e. any tumor spread that involves other tissues than those of the lymph nodes, spleen, thymus, Waldeyer’s tonsillar ring, appendix and Peyer’s patches.
  • High erythrocyte sedimentation rate (ESR) of 50mm/h if A‑symptoms are present and 30mm/h if B‑symptoms are present.
  • Involvement of three or more lymph node areas. Lymph node areas do not correspond to the lymph node regions according to the Ann Arbor classification system (a lymph node area may include several lymph node regions).
Regions Areas

The GHSG’s risk group classification system

On the basis of the risk factors mentioned above, the GHSG uses the following classification of risk groups in Hodgkin lymphoma patients. The treatment to be chosen is dependent on these risk groups:

Early stages

  • Stage IA or IB and IIA or IIB according to Ann Arbor without risk factors

Intermediate stages

  • Stage IA or IB and stage IIA with one or more risk factors
  • Stage IIB if a high ESR and/or > 3 involved lymph node areas are present as risk factors

Advanced stages

  • Stadium IIB if extranodal disease (E-lesions) and/or large mediastinal mass are present as risk factors
  • Stage IIIA or IIIB
  • Stage IVA or IVB