A formula for predicting the risk of a positive second-look laparotomy in epithelial ovarian cancer: implications for a randomized trial.
OBJECTIVE
To develop a formula to predict the risk of a positive second-look laparotomy.


METHODS
A retrospective review was performed on 89 patients who underwent second-look surgery following a complete clinical remission after cis-platin- or carboplatin-based chemotherapy. Logistic regression was used to develop a formula to predict the probability of a positive second look based on age, stage, grade of tumor, residual disease after initial surgery, and histologic type.


RESULTS
We identified three groups based on estimated probabilities: low probability (0.25 or less), intermediate probability (0.26-0.74), and high probability (0.75 or more). The low-probability group had an 8% chance of a positive second look, the high-probability group had an 82% chance of a positive second look, and the intermediate-probability group had the correct outcome predicted only 61% of the time. Survival curves paralleled these results and were significantly different for each group.


CONCLUSIONS
Using known prognostic factors, a formula can aid in implementation of a randomized clinical trial to test the efficacy of second-look laparotomy. This formula could exclude patients not suitable for randomization and give the investigator a better idea of the expected survival of various subgroups.
Morgan
M A
MA
Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia.
Noumoff
J S
JS
King
S
S
Mikuta
J J
JJ
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007813:Laparotomy; D015993:Life Tables; D016015:Logistic Models; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D012074:Remission Induction; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate