Role of an early second-look laparotomy in ovarian cancer.
Of a group of 68 patients treated with standard polychemotherapy (CAP-5), 52 were evaluated by an early second-look laparotomy, preferably after three cycles of treatment. Of 21 patients with initial tumor residuals smaller than 2 cm, only 5 had residual tumor, and of 31 patients with tumor larger than 2 cm, 27 had residuals, which could be surgically debulked in 9 patients. Surgical evaluation led to termination of treatment in 6 patients with stable disease and to intensification of treatment in 5 younger patients with microscopic or bulky residuals. Thus, the second-look influenced therapeutic decisions and treatment policy in a total of 20 patients. The procedure went without severe complications for the duration of anesthesia; there was no difference between biopsy and debulking, but a larger amount of blood was lost during debulking surgery. Second-look laparotomy is well tolerated but should be performed only in selected cases, depending on the therapeutic options available.
van Lith
J M
JM
Department of Gynecologic Oncology, University Hospital, Gronningen, The Netherlands.
Bouma
J
J
Aalders
J G
JG
Boonstra
H
H
Sleijfer
D T
DT
Willemse
P H
PH
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects; D008875:Middle Aged; D009017:Morbidity; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation