The role of surgery in the management of Hodgkin's disease.

The marked improvement in the prognosis of patients with Hodgkin's disease has resulted from advances in radiotherapy and chemotherapy. Success with these treatments depends upon accurate knowledge of the extent of the disease. Clinical assessment of the presence of abdominal disease is unreliable. Exploratory laparotomy with splenectomy, multiple lymph node biopsy and liver biopsy will reveal that preoperative assessment of the extent of the disease is inaccurate in 30 per cent of cases. The information obtained prevents relapses from undiagnosed abdominal disease and ensures that inappropriate radiotherapeutic treatment is not given to patients with disseminated disease.