Indications for and morbidity associated with operative staging in patients with lymphoma

Operative staging of patients with lymphoma has made an important contribution to the more accurate planning of treatment of this disease. Concomitant improvements in therapy have led to an increase in 5 year survival, particularly in patients with Hodgkin's disease. Nevertheless, considering risk versus benefit, several groups of patients might be spared increased morbidity from postoperative infection by restricting the operation to patients with stage I non-Hodgkin's lymphoma and to patients with Hodgkin's disease, stages I to III, without B symptoms. Groups having a greater risk of infection include all patients with non-Hodgkin's lymphoma and patients with Hodgkin's disease and B symptoms in whom operation is indicated. These exclusions from operative staging may not apply if accurate definition of the extent of disease is essential to evaluation of a new therapeutic program being assessed by a prospective randomized clinical trial.