Of 147 patients with reticulum cell sarcoma (RCS) from one institution, 33 (22.4%) required a laparotomy at the onset of their disease. T h e presenting signs and symptoms, surgical procedures, operative findings, treatment, and survival of these patients have been reviewed. The gastrointestinal tract was frequently involved by intrinsic tumor; in addition, extrinsic compressions of the bowel and ureters were common. Thus, the distribution of intraabdominal disease in RCS appears to differ from that in Hodgkin's disease. The findings are therefore relevant to the possible use of exploratory l a p arotomy for staging of RCS. Except for a small number of patients with localized RCS who received high doses of radiotherapy, the outlook in this group of patients was generally poor. Local surgical excision and radiotherapy appear ineffective in controlling the disease in the majority of patients. This study suggests that one must consider adding systemic chemotherapy early in the course of the disease, even though the tumor appears to be confined grossly to resected or irradiated areas.
EPORTS PUBLISHED SINCE 1969, HAVE DE-R scribed the value of exploratory laparotomy, with or without splenectomy in the staging of Hodgkin's disease.lo--'S This procedure has been useful in confirming the presence of clinically suspected retroperitoneal disease; in detecting involvement of lymph nodes in unsuspected areas such as the porta hepatis, mesentery, and hilum of the spleen; in verifying the presence or absence of splenic involvement and its correlation with splenic size, and in detection of clinically unsuspected Hodgkin's disease in tlie liver. T h e greater accuracy achieved by these staging procedures over that which can be achieved by clinical staging alone has been instrumental in improving treatment planning, in testing new therapeutic approaches, and in enhancing our From the