Laparotomy for staging of Hodgkins' disease

Laparotomy was used for staging Hodgkin's disease in a selected group of 71 patients over a 9-year period at the Cancer Control Agency of British Columbia. Operative results altered the staging in 30 patients and the treatment in 28 patients. Negative lymphangiograms were found to predict accurately the absence of abdominal lymph-node involvement. No investigation was as accurate as laparotomy in identifying subdiaphragmatic Hodgkin's disease. There were no operative deaths and the overall morbidity was 18%. The value of staging laparotomy depends on the adjustment of therapy to match the changes in staging made as a result of this procedure. Of specific advantage is the avoidance of unnecessary chemotherapy. Improved long-term survival as a result of staging laparotomy has yet to be proven.