Villar H V, Jones S E, Goodman G E, Grogan T M, Pond G D, Wangensteen S L
Arch Surg. 1983 Nov;118(11):1272-6. doi: 10.1001/archsurg.1983.01390110030008.
We examined and surgically restaged (using posttreatment laparotomy) 26 patients with stage III and IV Hodgkin's disease treated with combination chemotherapy and in apparent remission to determine the status of their clinical remission. Eleven patients had normal clinical restaging and surgical restaging. Fifteen patients had abnormal clinical restaging, mainly consisting of abnormal lymphangiograms or abdominal CT scans. Ten lymphangiograms were abnormal and could not exclude persistent lymphoma. Two of the 15 patients proved to have Hodgkin's disease involving the para-aortic nodes and the spleen. With a median follow-up of 24 months, two patients had relapses in supradiaphragmatic sites and no patient with a negative laparotomy had a recurrence abdominal sites. Restaging laparotomy in selected patients with Hodgkin's disease with abnormal lymphangiograms or CT scans may identify additional patients with residual lymphoma who require further therapy and, more importantly, may identify those patients who have no residual disease and, therefore, may be spared additional therapy. Mortality and morbidity were nil.
我们对26例接受联合化疗且处于明显缓解期的Ⅲ期和Ⅳ期霍奇金病患者进行了检查，并通过治疗后剖腹手术进行了手术分期，以确定其临床缓解状态。11例患者临床分期和手术分期均正常。15例患者临床分期异常，主要表现为淋巴管造影或腹部CT扫描异常。10例淋巴管造影异常，无法排除持续性淋巴瘤。15例患者中有2例被证实患有累及腹主动脉旁淋巴结和脾脏的霍奇金病。中位随访24个月，2例患者在膈上部位复发，而剖腹手术阴性的患者无腹部复发。对淋巴管造影或CT扫描异常的霍奇金病患者进行选择性剖腹手术分期，可能会发现更多需要进一步治疗的残留淋巴瘤患者，更重要的是，可能会发现那些没有残留疾病、因此可以避免额外治疗的患者。死亡率和发病率为零。
