The role of second-look laparotomy in the management of patients with Stage II, III and IV ovarian cancers following chemotherapy with cisplatin, adriamycin and cyclophosphamide

Summary

. Twenty-eight patients underwent a second-look laparotomy on completing triple agent chemotherapy with cisplatin, adriamycin and cyclophosphamide. The adequacy of the primary debulking procedure and the stage of tumour were the most significant factors associated with a good prognosis. Grade and histological type of tumour had no effect on survival rates. Eighteen patients were surgically free of disease at the second-look procedure and of these, all are alive and disease free with a mean survival time of 39 months. Of the 10 patients with positive second-look procedures, four are dead. The mean survival for patients with positive second look laparotomies was 30.7 months. Second-look laparotomy may contribute to increased survival if pelvic clearance was not attempted at initial staging laparotomy but should primarily be used to assess new agents and new combinations of chemotherapeutic agents and to define the optimum number of courses of chemotherapy.