With the advent of the use of large-dose (4,000 rads) radiotherapy to involved nodes, Hodgkin's disease has become a highly curable entity.1 The key to cure depends on the accurate knowledge of the nodes involved. Lymphangiograms are very useful in determining subdiaphragmatic involvement, but, unfortunately, about one third of them are equivocal. Beginning three years ago, exploratory laparotomy was carried out on those equivocal cases for more accurate staging. The findings from these early cases revealed a large number of cases of unsuspected or misdiagnosed spleen and liver involvement.2 This has led to the adoption of laparotomy with node biopsy, liver biopsy, and splenectomy in all new cases of Hodgkin's seen at the Stanford Medical Center.3
In the past, 100% of all premenopausal women receiving pelvic irradiation for Hodgkin's disease have become amenorrheic. Since the advent of the use of exploratory laparotomy for staging in many cases