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. 1980 Aug;42(2):284–291. doi: 10.1038/bjc.1980.228

Prognostic effect of early diagnostic splenectomy in Hodgkin's disease: a randomized trial.

J Askergren, M Björkholm, G Holm, B Johansson, H Mellstedt, R Sundblad, G Söderberg
PMCID: PMC2010376  PMID: 7426335

Abstract

A randomized trial is reported which evaluates the effect of early diagnostic splenectomy on the prognosis of patients with Hodgkin's disease (HD) and uncertain prognosis. This was started in January 1973 and concluded in April 1979. Sixty-seven patients were entered in the study and 31 were randomized for splenectomy. All patients except 2 received total nodal irradiation, excluding the splenic and hepatic areas. After 40 months' observation there was no difference between the groups in respect of survival and the number of recurrences. However, relapses occurred earlier in the splenectomized patients. Pneumococcal septicaemia was recorded in 2 splenectomized patients. It is concluded that prognosis is not improved by diagnostic splenectomy in HD patients with uncertain prognosis and treated with total nodal irradiation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aisenberg A. C., Goldman J. M., Raker J. W., Wang C. C. Spleen involvement at the onset of Hodgkin's disease. Ann Intern Med. 1971 Apr;74(4):544–547. doi: 10.7326/0003-4819-74-4-544. [DOI] [PubMed] [Google Scholar]
  2. Amiel J. L., Droz J. P. Staging and treatment of Hodgkin's disease. Eur J Cancer. 1978 Jan;14(1):1–4. doi: 10.1016/0014-2964(78)90131-7. [DOI] [PubMed] [Google Scholar]
  3. Andersen E., Videback A. Diagnostic laparotomy in Hodgkin's disease. Scand J Haematol. 1974;12(1):5–8. doi: 10.1111/j.1600-0609.1974.tb00173.x. [DOI] [PubMed] [Google Scholar]
  4. Björkholm M., Holm G., Mellstedt H., Johansson B., Askergren J., Söderberg G. Prognostic factors in Hodgkin's disease. I. Analysis of histopathology, stage distribution and results of therapy. Scand J Haematol. 1977 Nov;19(5):487–495. [PubMed] [Google Scholar]
  5. Björkholm M., Holm G., Mellstedt H. Persisting lymphocyte deficiences during remission in Hodgkin's disease. Clin Exp Immunol. 1977 Jun;28(3):389–393. [PMC free article] [PubMed] [Google Scholar]
  6. CUTLER S. J., EDERER F. Maximum utilization of the life table method in analyzing survival. J Chronic Dis. 1958 Dec;8(6):699–712. doi: 10.1016/0021-9681(58)90126-7. [DOI] [PubMed] [Google Scholar]
  7. Cannon W. B., Kaplan H. S., Dorfman R. F., Nelsen T. S. Staging laparotomy with splenectomy in Hodgkin's disease. Surg Annu. 1975;7:103–114. [PubMed] [Google Scholar]
  8. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  9. Chilcote R. R., Baehner R. L., Hammond D. Septicemia and meningitis in children splenectomized for hodgkin's disease. N Engl J Med. 1976 Oct 7;295(15):798–800. doi: 10.1056/NEJM197610072951502. [DOI] [PubMed] [Google Scholar]
  10. Glatstein E., Guernsey J. M., Rosenberg S. A., Kaplan H. S. The value of laparotomy and splenectomy in the staging of Hodgkin's disease. Cancer. 1969 Oct;24(4):709–718. doi: 10.1002/1097-0142(196910)24:4<709::aid-cncr2820240408>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  11. Holm G., Mellstedt H., Björkholm M., Johansson B., Killander D., Sundblad R., Söderberg G. Lymphocyte abnormalities in untreated patients with Hodgkin's disease. Cancer. 1976 Feb;37(2):751–762. doi: 10.1002/1097-0142(197602)37:2<751::aid-cncr2820370223>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  12. Host H., Abrahamsen A. F., Jorgensen O. G., Normann T. Laparotomy and splenectomy in the management of Hodgkin's disease. Scand J Haematol. 1973;10(5):327–336. doi: 10.1111/j.1600-0609.1973.tb00080.x. [DOI] [PubMed] [Google Scholar]
  13. Irving M. The role of surgery in the management of Hodgkin's disease. Br J Surg. 1975 Nov;62(11):853–862. doi: 10.1002/bjs.1800621102. [DOI] [PubMed] [Google Scholar]
  14. Kaplan H. S., Dorfman R. F., Nelsen T. S., Rosenberg S. A. Staging laparotomy and splenectomy in Hodgkin's disease: analysis of indications and patterns of involvement in 285 consecutive, unselected patients. Natl Cancer Inst Monogr. 1973 May;36:291–301. [PubMed] [Google Scholar]
  15. Lee Y. T., Lukes R. J., Finck E. J., Feinstein D. I., Powars D. R. Staging laparotomy and splenectomy for Hodgkin's disease. Am Surg. 1978 Apr;44(4):215–225. [PubMed] [Google Scholar]
  16. McClure J. N., Jr, Park Y. H. Solitary metastatic carcinoma of the spleen. South Med J. 1975 Jan;68(1):101–104. doi: 10.1097/00007611-197501000-00027. [DOI] [PubMed] [Google Scholar]
  17. Meeker W. R., Jr, Richardson J. D., West W. O., Parker J. C. Critical evaluation of laparotomy and splenectomy in Hodgkin's disease. Arch Surg. 1972 Aug;105(2):222–229. doi: 10.1001/archsurg.1972.04180080076013. [DOI] [PubMed] [Google Scholar]
  18. Panettiere F. J., Coltman C. A., Jr, Delaney F. C. Splenectomy, chemotherapy, and survival in Hodgkin disease. Arch Intern Med. 1977 Mar;137(3):341–343. [PubMed] [Google Scholar]
  19. Poulsen H., Bengmark S., Börjesson B., Flodgren P., Kallum B., Landberg T. Staging laparotomy with splenectomy in Hodgkin's disease. Acta Chir Scand. 1977;143(6):347–352. [PubMed] [Google Scholar]
  20. Rozman C., Triginer J., Ribas-Mundo M., Ferran C., Visa J., Gonzales E. The value of laparotomy and splenectomy in the staging of 56 patients with Hodgkin's disease. Acta Haematol. 1973;50(6):321–328. doi: 10.1159/000208367. [DOI] [PubMed] [Google Scholar]
  21. Smithers D. W., Lillicrap S. C., Barnes A. Patterns of lymph node involvement in relation to hypotheses about the modes of spread of Hodgkin's disease. Cancer. 1974 Nov;34(5):1779–1786. doi: 10.1002/1097-0142(197411)34:5<1779::aid-cncr2820340528>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  22. Somers R., Burgers J. M., Hart A. A., Van Coevorden S. J. Laparotomy in Hodgkin's disease; incidence of complications, significance of splenic involvement. Neth J Med. 1976;19(4-5):219–223. [PubMed] [Google Scholar]
  23. Weitzman S., Aisenberg A. C. Fulminant sepsis after the successful treatment of Hodgkin's disease. Am J Med. 1977 Jan;62(1):47–50. doi: 10.1016/0002-9343(77)90348-5. [DOI] [PubMed] [Google Scholar]

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