Staging laparotomy in Hodgkin's disease.

Fifty-two untreated patients with Hodgkin's disease underwent preoperative clinical assessment and staging laparotomy between 1971 and 1980. The preoperative studies of liver and spleen were of little value in assessing organ involvement with Hodgkin's disease. In eight out of 20 patients with positive lymphangiogram, staging laparotomy confirmed Hodgkin's disease in para-aortic or iliac lymph nodes. Fourteen patients were incorrectly staged by preoperative clinical assessment, eight patients being overstaged and six patients understaged. There were two surgical complications with no mortality. We conclude that surgical staging for Hodgkin's disease is valuable in making an accurate diagnosis and in determining the most effective treatment, but we believe that the patients must be centered in certain hospitals for clinical and pathological staging.