BRUCE A. CHABNER, M.D., F.A.C.P.; RALPH E. JOHNSON, M.D.; ROBERT C. YOUNG, M.D., F.A.C.P.; GEORGE P. CANELLOS, M.D., F.A.C.P.; SUSAN P. HUBBARD, R.N.; SANDRA K. JOHNSON, R.N.; VINCENT T. DeVITA Jr., M.D., F.A.C.P.
The yield of specific diagnostic procedures in the staging of non-Hodgkin's lymphoma was assessed in 170 consecutive patients who were evaluated with a sequence of diagnostic procedures. Stage III or Stage IV disease was established in 141 of 170 patients (80%) by nonsurgical procedures, including lymphangiography (positive in 78%), bone-marrow biopsy (positive in 39%), percutaneous liver biopsy (positive in 21%), and peritoneoscopy-directed liver biopsy (positive in 29% of those tested). Staging laparotomy showed disease outside conventional nodal irradiation fields in 21 of 26 patients with a positive lymphangiogram, but in only three of 17 patients with a negative lymphangiogram. The yield of staging procedures was highest in patients with nodular lymphomas, only 6% of whom were Stage I or Stage II after staging, but was lowest in patients with histiocytic lymphoma, 30% of whom had localized disease. This study shows that the presence of disseminated disease can be detected in the majority of patients with non-Hodgkin's lymphoma without the use of staging laparotomy.
CHABNER BA, JOHNSON RE, YOUNG RC, et al. Sequential Nonsurgical and Surgical Staging of Non-Hodgkin's Lymphoma. Ann Intern Med. 1976;85:149–154. doi: https://doi.org/10.7326/0003-4819-85-2-149
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Published: Ann Intern Med. 1976;85(2):149-154.
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