Laparotomy for staging of Hodgkin's and non-hodgkin's lymphoma

To justify the performance of an invasive technique as an aid to determining diagnosis and therapy in any condition, one must correlate the benefits derived with the adverse effects of performing that procedure. The review of the records of the patient indicates that clinical staging remains a moderately inaccurate means of assessing the extent of the disease in patients with Hodgkin's and non-Hodgkin's lymphoma. Lymphangiogram remains an aid to the surgeon in the localization of suspicious nodes. It is of greater accuracy in the patient with Hodgkin's lymphoma as compared with those with non-Hodgkin's lymphoma. Conversely, laparotomy for staging was not of as great a value in the patients in the non-Hodgkin's group as in those in the Hodgkin's group, and the incidence of complications was higher in the non-Hodgkin's group; especially in the patients with advanced disease. Laparotomy for staging is of significant benefit in the Hodgkin's lymphoma group, and the complication rate is not prohibitive. Laparotomy for staging in the non-Hodgkin's lymphoma group, on the other hand, is of less value than it is in the Hodgkin's group and is associated with a substantially higher complication rate in the face of advanced disease. In non-Hodgkin's lymphoma, individual decisions regarding laparotomy must be used, and the routine use of laparotomy may not be warranted.