[Studies of second-look operations (SLO) in ovarian cancer].
The Niigata Gynecological Cancer Society has been investigating the role of the second look operation (SLO) in the multi-disciplinary treatment of ovarian cancer, in cooperation with many other institutions, since 1981. One hundred seventy patients who underwent initial treatment for primary common epithelial ovarian cancer were analyzed in the present study. The distribution of clinical stages was as follows: stage I, 60 cases: stage II, 27 cases; stage III, 72 cases; and stage IV, 11 cases. Results; Five-year survival rates were 96% in stage I, 54% in stage II, 26% in stage III and 23% (4-year rate) in stage IV. Survival rates classified by the degree of completion of initial operation were 94% (5-year) in the complete extirpation group, 45% (4-year) in the group with residual tumor within 2 cm, 8% (4.5-year) in the group with residual tumor over 2 cm and 18% (5-year) in the exploratory laparotomy group. There were 89 cases of incomplete initial surgery, and 51 of them underwent SLO after FCAP therapy (Cisplatin + Adriamycin + Cyclophosphamide + 5-fluorouracil). Cancer was macroscopically completely removed in 20 cases (39.2%) by SLO, with the 4.5-year survival rate of 58%. In 25% of the cases with initial exploratory laparotomy group, the residual cancer was completely extirpated. There were 74 cases of complete initial surgery at stage I and stage II. They have been given FCAP therapy with 3 courses and maintenance chemotherapy. SLO was performed in 40 cases without clinical signs of recurrence. Recurrent cancer was noted in 2 cases (5%). On the other hand, 3 cases (12.5%) had recurred in 24 cases without SLO within about 2 years from initial operation. Consequently, SLO in the treatment of ovarian cancer is considered to be effective in the extirpation of residual cancer and in the early detection of cancer recurrence.
Yuzawa
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Dept. of Obstetrics & Gynecology, Niigata University School of Medicine.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007564:Japan; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D012086:Reoperation
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil