Restaging laparotomy for Hodgkin's disease

The role of restaging laparotomy (RL) in Hodgkin's Disease (HD) was studied in 39 patients. Four patients had two RL and two patients three RL; 47 RL were performed in the 39 patients. Twenty patients had prior radiotherapy, ten patients chemotherapy, and nine patients radiotherapy and chemotherapy. Twenty of the 39 patients had a prior staging laparotomy at the time of initial HD diagnosis. Four of 13 RL for suspected residual HD at the completion of treatment were positive. Two patients had nodal, one splenic, and one nodal plus ovarian cyst HD. Fifteen of 21 RL for suspected recurrent HD after a five-to-111-month (median = 36 months) disease-free interval were positive. Thirteen patients had nodal, seven splenic, four liver and two bone marrow HD. Five of ten RL to disclose intra-abdominal HD at the time of a peripheral node recurrence were positive. Subsequent treatment was altered in all five positive patients. One of three RL to confirm a clinical complete response disclosed residual HD in intraabdominal lymph nodes. All of the 22 negative RL patients remained clinically free of intra-abdominal disease for a median of 63 months after the procedure. RL is useful in assessing response after treatment of advanced HD. A negative RL is associated with prolonged disease-free survival.