[Laparotomy with splenectomy in Hodgkin's disease. Critical study of results in 123 patients]

123 laparotomies with splenectomy have been performed in 3 groups of patients. 1. 40 patients with infra-diaphragmatic relapses afer mantle field radiotherapy for supra-diaphragmatic disease. 2. 45 previously untreated patients. 3. 37 stages III B patients treated by intensive chemotherapy before splenectomy. Anatomical findings suggest that hematogenous dissemination may be responsible for spleen involvement and that spleen involvement may be suppressed by chemotherapy. In view of these data, chemotherapy in association with radiotherapy seems to be justified even in patients with apparently localised forms since the spleen may be involved in such patients at clinical presentation of the disease. From the preliminary results of studies which aim to appreciate the effectiveness of chemotherapy on splenic lesions, the need for routine laparotomy and splenectomy should be reevaluated.