Results of surgical staging in Hodgkin's disease.

The results of surgical staging in Hodgkin's disease in 107 patients under the care of one surgeon over an 8-year period are presented. The inaccuracy of clinical staging is re-emphasized as 43 per cent of patients had their disease stage altered by surgical staging. Lymphangiography correctly predicted the presence of intra-abdominal disease in only 70 per cent of patients. Spleen size was not an indication of involvement, and furthermore the spleen was involved by disease in the absence of nodal involvement in 6 patients. In 2 cases mesenteric nodes were involved in the absence of pancreatic or coeliac nodal involvement. As a consequence of surgical staging many patients received a more extensive field of radiotherapy, and 18 per cent of patients were treated by combination chemotherapy instead of radiotherapy. There was no hospital mortality and a low operative morbidity following surgical staging. At present surgical staging is an essential part of the overall strategy of management of patients with Hodgkin's disease.