Second Look Laparoscopy Surgery Boon for Fully Treated Patients of CA Ovary but Raising CA 125 Levels and Localised Tumors

Abstract

Study Objective To define role of 2nd look laparoscopy in fully treated in Ca ovary patient with persistent raised Ca 125 levels. Design Prospective analysis. Setting Patient undervent 3D laparoscopy, all procedures done by experienced and qualified team. Patients or Participants Fully treated Ca ovary patient with raised Ca 125 levels. Interventions 2nd look laparoscopy with excision of Case1- Retroperitoneal solid cystic mass near left iliac vessels. Case 2- Aortocaval (para-aortic) node. Case 3- solid cystic recurrent mass from remnant of left ovary. Case 4- Peritoneal deposit from anterior abdominal wall and omental nodule. Measurements and Main Results all the patient reviewed at monthly interval followed by 3 monthly interval with Ca 125 level & 3 monthly USG (A+P), none of the patient needed further chemotherapy as Ca 125 continues to be normal and USG (A+P) WNL, PET scan done at the end of 6 months did not reveal any evidence of recurrence. Median follow-up 18 months. All patients are diseased free. Conclusion 2nd look laparoscopy was always an armamentarium for gynecologist but using laparoscopy 2nd look surgery become beneficial for specific group of patients with persistent raised CA125 level & no major recurrence on imaging. To define role of 2nd look laparoscopy in fully treated in Ca ovary patient with persistent raised Ca 125 levels. Prospective analysis. Patient undervent 3D laparoscopy, all procedures done by experienced and qualified team. Fully treated Ca ovary patient with raised Ca 125 levels. 2nd look laparoscopy with excision of Case1- Retroperitoneal solid cystic mass near left iliac vessels. Case 2- Aortocaval (para-aortic) node. Case 3- solid cystic recurrent mass from remnant of left ovary. Case 4- Peritoneal deposit from anterior abdominal wall and omental nodule. all the patient reviewed at monthly interval followed by 3 monthly interval with Ca 125 level & 3 monthly USG (A+P), none of the patient needed further chemotherapy as Ca 125 continues to be normal and USG (A+P) WNL, PET scan done at the end of 6 months did not reveal any evidence of recurrence. Median follow-up 18 months. All patients are diseased free. 2nd look laparoscopy was always an armamentarium for gynecologist but using laparoscopy 2nd look surgery become beneficial for specific group of patients with persistent raised CA125 level & no major recurrence on imaging.