Negative second-look laparotomy does not preclude recurrence in stage I ovarian carcinoma of any histological variety.
Between January 1980 and June 1991, 56 patients with Stage I ovarian carcinoma of different histological varieties were submitted to a second-look laparotomy (SLL) at the University Clinic (Hospital de Cruces) of Bilbao, Spain. The operation was performed upon all patients one year after initial surgery, after completion of adjuvant chemotherapy, or after one year of observation in those cases that were not treated postoperatively. The SLL was negative in 55 of cases and positive in one. The median follow-up after SLL was 59 months. Of the 55 negative cases, four (7.3%) have had a recurrence of their tumor during their long-term follow-up. Three had epithelial tumors and had received complete postoperative chemotherapy, and the fourth was a dysgerminoma. The three patients with epithelial tumors have died under second-line chemotherapy, whereas the dysgerminoma patient is responding well to rescue polychemotherapy. In view of these results, it is useless and probably unethical to perform second-look laparotomy in Stage I ovarian carcinoma if the initial staging was properly performed.
Schneider
J
J
Department of Obstetrics and Gynecology, Hospital de Cruces, Universidad del Pais Vasco, Baracaldo (Vizcaya), Spain.
Centeno
M M
MM
Montoya
F
F
Rodriguez-Escudero
F J
FJ
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D004407:Dysgerminoma / Q000188:drug therapy / Q000601:surgery*; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D012086:Reoperation