HODGKINS-DISEASE - EVALUATION OF STAGING LAPAROTOMY IN 82 PATIENTS

The findings of staging laparotomies in 82 patients with Hodgkin''s disease are presented. Subdiaphragmatic disease was discovered in 30 patients, the spleen being the most common site of involvement (26 patients). Staging was advanced in 23 patients and reduced in 3, with consequent changes in the treatment plan of these patients. In a further 4 patients, treatment was altered by the distribution of subdiaphragmatic disease discovered, without any change in stage. Lymphangiography was an unreliable staging procedure. This was due to the frequent presence of disease in areas outside the lymphangiographic field (spleen, mesenteric and celiac nodes) rather than inaccuracy of the procedure itself. Correlation of laparatomy findings with presenting sites of disease failed to identify any patient group which, on clinical grounds, had a low probability of abdominal involvement and might be spared a laparotomy. No patient died as a result of the operation. Postoperative morbidity (3 major, 8 minor complications) was considered acceptable in view of the value of the information obtained to patient management.