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


METHODS
A retrospective chart review was conducted on 21 patients with tubal carcinoma who underwent second-look laparotomy following cytoreductive surgery and platinum-based combination chemotherapy.


RESULTS
Thirteen patients (62%) were found to be free of disease at second-look operation. Neither stage nor grade were predictive of findings at second-look procedure. The absence of gross residual disease following primary surgery was the only predictor of disease-free status at second-look laparotomy (p < 0.01). With a mean follow-up of 49 months among the survivors, four (31%) of the patients with negative second-look laparotomy have had a recurrence. The median survival following a positive second-look laparotomy was 18 months (range 5-42 months).


CONCLUSIONS
Second-look laparotomy provides useful prognostic information in patients with tubal carcinoma. The high rate of recurrent disease after negative second-look laparotomy, and the lack of an effective second-line treatment in patients with persistent disease, represent major criticisms of this procedure.
Cormio
G
G
Department of Obstetrics and Gynecology, University of Bari, Italy.
Gabriele
A
A
Maneo
A
A
Marzola
M
M
Lissoni
A
A
Mangioni
C
C
D000328:Adult; D005185:Fallopian Tube Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging