Watch and Wait, Salvage Later

For this patient (1) with localized resected nodular lymphocyte predominant Hodgkin lymphoma, we favor a "watch and wait" approach or radiation therapy alone after a frank discussion of the pros and cons of each approach (2). Observation after complete resection in early-stage disease has been studied predominantly in the pediatric population, with 1 study showing an overall progression-free survival of 67% at 26 months (3). In adults there are little data of observation alone. In 1 study the addition of radiation therapy improved progression-free survival.

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