Critical value of laparotomy with splenectomy in XXXX as restaging procedure after chemotherapy.

@entity1 @entity978 @entity981 @entity5
38 @entity1 with @entity978 underwent laparotomy with splenectomy as restaging procedure after first line chemotherapy which included MOPP, ABVD, or both. 28 @entity1 were judged to be in clinical complete remission (CR) and 10 were resistant or had relapsed. Among @entity1 in CR, 27 (96%) were confirmed to be in pathological CR; among @entity1 resistant or relapsed, 9 (90%) were confirmed to have disease in the abdomen or retroperitoneum. The therapy for @entity1 in clinical remission before laparotomy consisted of TNI or sTNI in 19 @entity1 , mediastinal radiation in 6 @entity1 and no further therapy in the remaining 3 @entity1 . No significant differences were seen in survival and relapse-free survival between those @entity1 treated by extensive and those treated by local radiotherapy or no further therapy. Instead, among those @entity1 who received extensive radiotherapy 3 developed @entity981 ( @entity981 ). The therapy for this group of @entity1 consisted of further chemotherapy in 7 who had concomitant liver involvement and TNI in the remaining 3 who had the disease confined to the spleen and/or lymph nodes. Among these @entity1 , only 3 obtained CR; 2 with radiation and 1 who was resistant to MOPP, with ABVD. This study leads us to re-consider the role of laparotomy in @entity5 which should be used as non-routine procedure only in selected @entity1 without poor prognostic factors who may be cured by radiotherapy alone. In @entity1 resistant to chemotherapy, an early evaluation of disease in the abdomen may be useful for a better salvage treatment.
