Michel G, Zarca D, Castaigne D, Prade M
Department of Surgery, Institut Gustave-Roussy, Villejuif, France.
Eur J Surg Oncol. 1989 Jun;15(3):201-4.
During the 8-year period from 1976 to 1984, 202 patients with a primary ovarian cancer underwent a second-look laparotomy at the Institut Gustave-Roussy (Villejuif). One hundred and nine patients had a macroscopic tumour, in 77 of which there was clinical evidence of disease before the laparotomy. Fifty-seven patients underwent an optimal resection of the tumour (largest residual tumour less than 2 cm) and 52 underwent non-optimal cytoreductive surgery or isolated biopsies. In 22 cases the optimal resection necessitated a bowel resection. Survival curves suggest: (1) that the removal of macroscopic residual disease does not improve life expectancy except in the cases of optimal resection without bowel resection. (2) When there is evidence of disease before the second-look operation the prognosis remains the same whatever the surgery performed.
在1976年至1984年的8年期间，202例原发性卵巢癌患者在古斯塔夫 - 鲁西研究所（维勒瑞夫）接受了二次剖腹探查术。109例患者有肉眼可见的肿瘤，其中77例在剖腹探查术前有疾病的临床证据。57例患者接受了肿瘤的最佳切除（最大残留肿瘤小于2厘米），52例接受了非最佳的细胞减灭术或单纯活检。在22例中，最佳切除需要进行肠切除。生存曲线表明：（1）除了在未进行肠切除的最佳切除病例中，切除肉眼可见的残留病灶并不能提高预期寿命。（2）当二次探查手术前有疾病证据时，无论进行何种手术，预后都相同。
