The value of laparotomy and splenectomy in the staging of Hodgkin's disease

Experience with 65 patients with biopsy-proven Hodgkin's disease who were subjected to laparotomy, splenectomy, liver biopsy, and para-aortic lymph node biopsy is presented. There were no major complications. Histologic findings in the para-aortic nodes, liver, and spleen are presented. A general correlation was observed between the occurrence of systemic symptoms and the extent of involvement below the diaphragm. There was no instance of liver involvement without concomitant splenic involvement. It is concluded that laparotomy with splenectomy is a valuable procedure for the more precise delineation of intra-abdominal sites of involvement in Hodgkin's disease prior to the initiation of extended field megavoltage radiation therapy with curative intent.