Clinical Stage IA (Limited Patch and Plaque) Mycosis Fungoides: A Long-term Outcome Analysis

doi:10.1001/archderm.1996.03890350051009

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Vol. 132 No. 11, November 1996

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Clinical Stage IA (Limited Patch and Plaque) Mycosis Fungoides

A Long-term Outcome Analysis

Youn H. Kim, MD; Reini A. Jensen; Garrett L. Watanabe; Anna Varghese; Richard T. Hoppe, MD

Arch Dermatol. 1996;132(11):1309-1313.

Abstract

Objectives
To study the long-term results of treatment of patients withstage IA mycosis fungoides and analyze the factors related todisease progression and the effect of initial therapy on survivaland freedom from relapse.

Design
A single-center, 32 $1/2$ -year, retrospective cohort analysis.

Setting
Private referral medical center.

Patients
One hundred twenty-two patients with clinical stage IA (T1,N0, M0) mycosis fungoides.

Main Outcome Measures
Long-term actuarial survival and freedom-from-relapse resultsas calculated by the technique of Kaplan-Meier.

Results
The long-term (30-year) survival of patients with stage IA mycosisfungoides is similar to the expected survival of a race-, age-,and sex-matched control population. The median survival of thisgroup has not been reached at 32 $1/2$ years. Eleven patients (9%)who progressed to more advanced disease had a lower completeresponse rate to initial therapy than did other patients (36%vs 82%) and an older mean age than did other patients with T1disease (61 vs 48 years, P<.05). Only 3 (2%) of 122 patientsdied of disease. Among stage IA patients who achieved a completeresponse, 25% are relapsefree at 10 years. Patients who receivedtotal skin electron beam therapy (n=34) had a more favorablefreedomfrom-relapse outcome than those treated with topicalmechlorethamine hydrochloride (nitrogen mustard) (n=73, P<.05).No significant difference was seen in the long-term survivalbetween the 2 treatment groups.

Conclusions
Patients with clinical stage IA mycosis fungoides treated atStanford University do not have an altered life expectancy.Fewer than 10% progressed to more advanced stages and few diedof disease. Although the response rate to total skin electronbeam therapy was superior to that of topical mechlorethamine,the longterm survival results were similar. Topical mechlorethamineis a cost-effective and convenient therapy for patients withlimited patch and plaque mycosis fungoides.

Arch Dermatol. 1996;132:1309-1313

Author Affiliations

From the Departments of Dermatology (Dr Kim, Ms Jensen, and Mr Watanabe) and Radiation Oncology (Ms Varghese and Dr Hoppe), Stanford University School of Medicine, Stanford, Calif.

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