'Secondary' operative staging of patients with lymphoma

Secondary operative staging (diagnostic celiotomy after initial lymphoma staging and treatment) is of value in selected patients with Hodgkin's disease if, after appropriate clinical staging, there remains a reasonable doubt concerning the presence of residual or recurrent lymphoma. In our experience, although signs indicating possible recurrence were present in 35 patients, only 20 of these were found to have Hodgkin's disease within the abdomen at operation. These findings allowed us to restrict our intensive therapy to those with documented disease and to withhold potentially harmful treatment from the remaining subjects who on follow-up have shown no evidence to date of subsequent recurrence within the abdomen. The utilization of secondary operative staging in ten patients with non-Hodgkin's lymphoma has been less productive and is not recommended on the basis of our limited current experience.