Staging laparotomy in Hodgkin's disease

Staging laparotomy is a useful procedure as long as regional radiotherapy continues to be the primary modality of treatment for early Hodgkin's disease. However, many oncologists have extended the indications for systemic chemotherapeutic agents. Studies are in progress to evaluate the effectiveness of chemotherapy alone for all patients with B symptoms as well as for those with stages I and II disease associated with large mediastinal masses or lymphocyte depletion histology. If therapeutic practices change significantly in the future, there may be fewer indications for careful staging. The natural history of treatment of cancers in a sophisticated therapeutic environment is that more careful staging is required to utilize the vast array of therapies being developed to improve prognosis. In all likelihood staging laparotomy in some form will continue to be a part of the management scheme for patients with Hodgkin's disease.