A retrospective clinical and histopathological review was made of 499 previously untreated cases of non-Hodgkin's lymphoma with adequate initial biopsy material diagnosed at Memorial Hospital between 1958 and 1969. Three hundred-eighty-four cases (77%) had diffuse, 104 (21%) nodular, nine (2%) nodular and diffuse, and two (4%) unclassifiable histologic types. Overall median survival was 16 months, and 79% of the patients died with lymphoma. For all treatments, survival of responding patients was the same as that of nonresponders, a reflection of the palliative approach. Significant differences in survival were found between patients in the various Ann Arbor stages. Median survival was 42 months for the nodular group and 11.5 months for the diffuse (P < 0.001). The ten-year survival was 12% for the diffuse and 22% for the nodular patients. The overall difference in survival was due to early deaths in the diffuse group. Long-term follow-up is necessary to appreciate the usual fatal course of patients with all types of non-Hodgkin's lymphomas treated conservatively.
Cancer 51:lOl-109, 1983. HE WIDE VARIATION in the prognosis Of adult pa-T tients with non-Hodgkin's lymphoma has presented the clinician with serious problems in selecting appropriate treatment for an individual patient. Al- though electron microscopic, cytochemical, immunologic, and enzymatic marker studies have provided new information about the biology of these malignancies, their natural history has been less completely studied. A clinical description of the non-Hodgkin's lymphomas was reported from this institution 20 years ago by Rosenberg et d.' This pioneering study made many clinical observations which are still valid today despite the use of a histopathologic nomenclature no longer currently in use. In 1966, Rappaport formulated a histopathologic classification for the non-Hodgkin's lymphomas which has gained wide acceptance throughout the United States.' A classic study by Jones and colleagues3 applied