Lymphomas of the head and neck in the pediatric population

Objective: Little is known about the incidence and survival outcomes of pediatric patients with head and neck (HN) lymphomas in Asian populations. This study sought to identify the incidence of HN involvement of pediatric lymphomas and to identify factors prognostic of patient survival. Methods: We reviewed the medical records of all children aged 0-14 years with previously untreated lymphomas of HN region and compared patient clinicopathologic characteristics and final outcomes in patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). Potential prognostic factors for patient survival were investigated. Results: Of 106 eligible lymphoma patients, 45 (42.5%; 31 boys and 14 girls) showed HN involvement. Overall, NHL (n = 37) showed more unusual and aggressive presentations than did HD (n = 8) in the head and neck region. Cervical lymphadenopathy was frequently observed (30/45, 66.7%) in these patients. Involvement of extralymphatic head and neck sites was found in 15 of 37 NHL patients (40.5%) but not in any HD patients (p=0.027). Five-year disease-free survival (DFS) of all HN lymphoma patients was 76.0%. On multivariate analysis, advanced stage and absence of complete remission following 3 cycles of chemotherapy were poor prognostic indicators of patient survival (p < 0.05). Conclusions: The incidence of HN involvement in pediatric lymphomas was 42.5% in the studied population. Stage of the lesion and early response to chemotherapy were independent factors prognostic of patient survival. (C) 2007 Elsevier Ireland Ltd. All rights reserved.