[Chemotherapy and surgical procedure in the management of ovarian malignancies. Evaluation of second look operations].

Recently, the second-look operation (SLO) has become an established part of the protocol of many centers for patients with ovarian malignancies who have received chemotherapy. This surgical procedure for ovarian cancer can be used for various purposes, therapeutic or diagnostic. The first main indication of SLO is resection of a residual tumor by as great an extent as possible following chemotherapy. In our experience, the prognosis was more favorable in patients in whom the residual tumor had been reduced to 2 cm or less upon SLO than in those in which the residual tumor was larger than 2 cm. In addition, maximum possible reduction of the advanced disease at the time of initial operation serves to enhance the effectiveness of chemotherapy. The second main indication is evaluation of the disease with the intent of stopping chemotherapy and assessing any signs of early recurrence. In our experience, approximately 50% of patients who had cancer at the time of SLO were clinically free of the disease prior to the operation. Therefore, we think that effective combination of chemotherapy and SLO are the key to improving patients, prognoses.