Abstract
Second-look laparotomy is confined to patients who have no evidence of disease after appropriate chemotherapy and is recommended in an attempt to determine the need for further treatment. This study involved 59 patients who had previous appropriate surgery for ovarian cancer and had subsequent treatment, with no further clinical evidence of disease. Despite this, 32 (54%) patients had residual malignancy; most were patients with stage III and IV disease. Conversely, patients with grade 1 tumors had a higher proportion of negative findings (71%). The amount of disease remaining after initial surgery correlated well with the second-look findings. Although there have been no major complications, 4 of the 32 patients with “negative” second-look operations subsequently suffered recurrence. However, the survival rates were significant. At 4 years, the survival of patients who had negative second-look operations was 86% compared with 53% for patients who had malignancy diagnosed at second-look operations.
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