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December 1972

The Influence of Laparotomy on Management Decisions in Hodgkin's Disease

Author Affiliations


From the Joint Center for Radiation Therapy; the Peter Bent Brigham Hospital; the New England Deaconess Hospital; the Beth Israel Hospital; the Boston Hospital for Women; and the departments of radiation therapy and medicine, Harvard Medical School, Boston.

Arch Intern Med. 1972;130(6):844-848. doi:10.1001/archinte.1972.03650060036006

Fifty-four patients with Hodgkin's disease underwent laparotomy for splenectomy, wedge liver biopsy, and biopsies of intraabdominal lymph nodes. Preoperative disease staging was changed in 17 of the 54 patients (31.4%) because of findings at laparotomy. The plan for management prior to operation was altered in 20 patients (37%) as a consequence of the procedure. Ten patients received less nodal irradiation and two were given more than planned. Two patients had nodal irradiation rather than chemotherapy and four received cytotoxic drugs instead of x-ray therapy. Accuracy of preoperative diagnostic measures of intraabdominal disease was evaluated by laparotomy, and significant error was found in the clinical evaluation of disease below the diaphragm. Results of laparotomy with splenectomy, liver biopsy, and intraabdominal lymph node biopsies have a significant influence on management decisions in Hodgkin's disease patients.

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