Extranodal Involvement in Hodgkin’s Lymphoma: A Retrospective Analysis of Survival Outcomes and Prognostic Factors at a Single-Center Study

Abstract Extranodal involvement in Hodgkin’s lymphoma (HL) indicates advanced disease and may negatively impact survival. This study aimed to evaluate the influence of extranodal involvement on progression-free survival (PFS) and overall survival (OS) and to identify prognostic factors related to extranodal site involvement. This retrospective study analyzed 855 HL patients treated at a single oncology center from 2003 to 2020. Extranodal involvement was identified using imaging (CT, PET/CT, MRI) and biopsy. Survival outcomes were assessed with Kaplan-Meier estimates, and Cox regression was used to evaluate prognostic factors for PFS and OS. Extranodal involvement was present in 181 patients, most commonly affecting the lungs, bone, liver, and chest wall. Extranodal involvement significantly reduced both PFS and OS in patients ( p < 0.02 for PFS; p < 0.001 for OS). The worst survival among 181 patients with extranodal involvement was observed in patients with liver involvement ( p = 0.004 for PFS; p < 0.033 for OS). Conversely, localized involvement of extralymphatic sites showed better survival outcomes ( p < 0.009 for PFS; p < 0.011 for OS). Age, gender, clinical stage, and radiotherapy were independent survival predictors. Extranodal involvement, particularly in the liver, is associated with poorer outcomes in HL patients. These results emphasize the importance of tailoring treatment strategies based on the specific sites of extranodal disease.