Second-look laparotomy for ovarian cancer provides reliable prognostic information and improves survival.

Abstract

From 1990 to 1995, 120 consecutive patients with stage IIIC and IV ovarian carcinoma underwent surgical cytoreduction to < or = 1-cm residual disease followed by platinum-based chemotherapy. At the conclusion of chemotherapy all patients who were clinically disease free and whose CA-125 was < 35 were offered a second-look operation that obtained at least 100 tissue specimens. Of 107 patients who qualified for second look, 78 underwent the procedure. Forty-three (55.1%) had negative pathology, 20 (25.6%) were microscopically positive, and 15 (19.2%) had gross disease. Patients with positive findings received individualized salvage therapy. Patient age (P = 0.01) and the number of implants at primary surgery (P = 0.004) correlated with second-look results. Twelve (27.9%) of the patients with negative pathology have recurred. Eleven of these patients had metastatic disease > or = 10 cm at primary surgery (P = 0.003). Patients refusing second look had a median survival of 39.1 months. Approximately 60% of patients who underwent second look remain alive. Stepwise logistic regression selected two covariates significantly affecting survival: the number of implants at primary surgery (P = 0.0130) and performance of a second look (P = 0.0103). Using the protocol described in a population of optimally resected patients with advanced-stage ovarian cancer, second-look laparotomy can impact positively on survival. Patients with > 10-cm metastatic disease at primary surgery and negative second-look findings should be the focus of future protocols for consolidation chemotherapy.

Cite this paper

@article{Friedman1997SecondlookLF, title={Second-look laparotomy for ovarian cancer provides reliable prognostic information and improves survival.}, author={Randy L. Friedman and Scott M . Eisenkop and Hung Jen Wang}, journal={Gynecologic oncology}, year={1997}, volume={67 1}, pages={88-94} }