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Prognostic impact of systemic and regional lymph node chemotherapy in conjunction with radical lymph node dissection after preoperative chemotherapy. A problem with statistical reasoning?
The purpose of this retrospective study was to determine if systemic and regional lymph node chemotherapy (LNC) have an independent prognostic impact in patients who have undergone LNC. Two hundred twenty patients with clinically localized or regional nodal lymphomas (NL) treated according to the current international recommendations were included in this study. The tumor stage in these patients was T1N0M0 in 125 patients, T2N0M0 in 62 patients, T3N0M0 in 36 patients, and T4N0M0 in 11 patients. Preoperative chemotherapy was given to 171 patients. Systemic chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or cyclophosphamide, adriamycin, vincristine, and prednisone (CAVP) was given to 71 patients and regional chemotherapy was administered to 90 patients. Fifty-eight patients were treated by LNC alone and 108 patients were treated by LNC in conjunction with systemic or regional chemotherapy. Lymphatic radiotherapy was given to 36 patients. For analysis, patients were grouped as follows: LNC only, LNC with systemic chemotherapy, and LNC with regional chemotherapy. Survival analysis was performed using Kaplan-Meier survival curves and differences in survival between the groups were analyzed using the log rank test. The influence of patient age, pathological subtype, tumor stage, and extent of lymphadenectomy on survival was also analyzed. There was a statistically significant difference in survival between patients treated with regional therapy only and those treated with regional therapy plus systemic chemotherapy. However, survival analysis revealed no independent prognostic impact of LNC when administered in conjunction with systemic chemotherapy.We have three high school girls who keep active through their sports. One is a 4.0 honor roll student, one is a 4.0 student, and the last is a 4.0 student.
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