Evaluation of the second-look laparotomy in the management of carcinoma of the ovary.

One hundred and thirty four patients had a second-look laparotomy in the course of management of cancer of the ovary. Patients were stratified according to four indications: (1) resection of the residual tumor following chemotherapy or radiation therapy, (2) evaluation of the disease with intent to stop chemotherapy and assess signs of recurrence or persistence, (3) restaging, and (4) surgical indication. The first group consisted of 35 patients. In 20 of 35 patients in this group, complete removal of the residual tumor (residual less than or equal to 2 cm) was possible, and the survival curves indicated that removal of the residual tumor during the second-look laparotomy improved the survival rate. The second group consisted of 77 patients. No evidence of disease was found in 44 of the 77 patients in this group. Four patients with negative second-look laparotomy developed recurrences, and three patients died from the disease. The third group consisted of seven patients. In one of seven patients in this group, the stage was modified after second-look laparotomy.