Second-look laparotomy in carcinoma of the fallopian tube.
OBJECTIVE
To evaluate the role of second-look laparotomy following platinum-based chemotherapy in patients with fallopian tube cancer.


METHODS
We conducted a retrospective chart review of 35 patients with tubal cancer who underwent a second-look laparotomy following cytoreductive surgery and platinum-based combination chemotherapy.


RESULTS
The distribution by stage was as follows: I, three (9%); II, five (14%); III, 24 (69%); and IV, two (6%); one patient was inadequately staged. The tumor grade was recorded in 31 patients, and 80% of these were grade 2 or 3. Twenty-one of the 35 patients (60%) were found to be free of disease at second-look operation. Neither stage nor grade were predictive of findings at the second-look procedure, although none of the five patients with stage I disease and/or grade 1 tumor had disease found at second-look surgery. The absence of gross residual disease following primary surgery was the strongest predictor of disease-free status at second-look laparotomy (P < .01). With a mean follow-up of 50 months among the survivors, only four (19%) of the patients with no evidence of tumor at reexploration have had a recurrence.


CONCLUSIONS
Second-look laparotomy provides useful prognostic information in patients with tubal cancer; approximately 80% of patients who have a negative second-look following platinum-based chemotherapy will remain disease-free.
Barakat
R R
RR
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
Rubin
S C
SC
Saigo
P E
PE
Lewis
J L
JL
Jones
W B
WB
Curtin
J P
JP
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate