Predictors and outcomes of recurrent disease after a negative second look laparotomy.
OBJECTIVE
To analyze the predictors and outcomes of recurrent disease in patients with epithelial ovarian carcinoma (EOC) after a negative second look laparotomy (SLL).


METHODS
One hundred nine EOC patients with a negative SLL treated at Hacettepe Hospital were retrospectively analyzed.


RESULTS
Of these patients, 70 (64.2%) had no evidence of disease during follow up while remaining 39 (35.8%) had recurrence. Majority of the recurrences (82.1%) were detected within the initial 2 years of the SLL procedure. Multivariate analysis revealed stage and grade of the disease to be the significant predictors for the recurrent disease (P < 0.01 and P = 0.025, respectively). A second analysis with respect to initial metastatic sites revealed omental metastatis was significantly associated with recurrent disease (P < 0.001). Survival of patients with a recurrent disease was significantly poorer and dropped abruptly once a recurrence is developed.


CONCLUSIONS
Patients with initial omental metastasis, advanced stage and high grade tumors have highest risk for developing recurrences after a (-) SLL. Most of the recurrences develop during the initial 2 years following the (-) SLL and survival drops to less than 2 years once a recurrence is found.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Baskent University School of Medicine, Tandogan, Ankara, Turkey.
Ali
A
Ayhan
Murat
M
Gultekin
Polat
P
Dursun
Nasuh Utku
NU
Dogan
Guldeniz
G
Aksan
Suleyman
S
Guven
Kunter
K
Yuce
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D024162:Second-Look Surgery; D016896:Treatment Outcome