The two main elements that identify the severity<\/strong> of the disease in the case of lymphomas are the histological subtype of lymphoma and its spread within the body. It is obvious that the more a tumour is spread, more numerous cancer cells are and the more difficult it will be to eradicate it. In this respect, it is important to determine how many lymph node stations are involved and whether extralymphatic organs are involved and which ones.<\/p>\n A recurring question is “How important is the early diagnosis<\/a> of Lymphoma for the prognosis?\u201d Compared to other types of cancer, lymphomas can give symptoms<\/a> very late or not at all and therefore reach diagnosis at an already advanced stage of the disease (so-called stage IV). Obviously, since it is a tumor pathology, it is better not to waste time, but an early diagnosis is much less relevant compared to other cancers. Lymphomas are in fact a particular neoplasm for which the classical concept of “metastases” typical of solid tumors does not apply. Lymphomas are systemic diseases in themselves and, although their spread as identified by the staging also provides prognostic indications, there are no tests to demonstrate that early diagnosis will give a better prognosis, as with other cancers like colorectal or breast cancer. The only useful advice is to pay particular attention to the enlargement of one or more lymph nodes in the absence of other infectious or inflammatory causes<\/strong>.<\/p>\n The therapy<\/a> setting of each form of lymphoma passes through an accurate assessment of the prognosis whose fundamentals are:<\/p>\n \u2022 precise diagnosis of the lymphoma subtype and its molecular markers; In the case of elderly patients, geriatric evaluation, which can be calculated using specific instruments, is particularly useful. These tools are described in the following brochure, which can be downloaded (only in Italian language) in pdf format:<\/p>\n Elderly Patient<\/a><\/p>\n As for other types of tumors, various stages of disease spread are defined and the set of radiological and laboratory analyzes<\/a> performed to clarify the spread of the disease constitutes the staging<\/strong> process. The other very important element for establishing the prognosis is the definition of the degree of biological aggressiveness of the disease. In fact there are many histological subtypes<\/strong> of lymphoma: some with an indolent evolutionary trend and others very aggressive. There may be widespread forms that are characterized by poor development and have benign spontaneous prognosis. On the other hand, some lymphomas that at the onset may appear to be limited to a few lymph node stations may have very aggressive behavior and unfavorable prognosis. A thorough and correct histological diagnosis<\/strong> of the lymphoma subtype, completed today by refined molecular tests, is therefore the second cornerstone of the definition of prognosis.<\/p>\n The basic system to define the stages of the disease<\/strong> of the various types of lymphoma is still the one proposed to Ann Arbor many years ago:<\/p>\n \u2022 Stage I: one single lymph node district concerned
\n\u2022 staging (extent of the disease in the various districts of the organism);
\n\u2022 calculation (if any) of the prognostic risk index;
\n\u2022 evaluation of the general condition of the patient and his ability to tolerate the most appropriate therapy.<\/p>\nStadiation<\/h2>\n
\n\u2022 Stage II: Two or more affected lymph node districts located either above the diaphragm (neck, armpits, chest) or below the diaphragm (abdomen, pelvic area, groin)
\n\u2022 Stage III: involvement of lymph nodes both above and below the diaphragm
\n\u2022 Stage IV: Disease affecting lymph nodes and other extra-lymphatic organs (e.g. liver, spleen, lungs, bone marrow)<\/p>\n
![\"Staging](\"https:\/\/filinf.it\/wp-content\/uploads\/2018\/08\/Staging-Eng-1024x552.png\" "\\"\\"")
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