[Second-look laparotomy or the search for curable stage III FIGO ovarian epitheliomas. Apropos of a series of 35 cases].

The authors report their experience in 35 cases of second-look laparotomy performed on 35 patients in the Claudius Regaud Centre. The actuarial survival rate at 3 years of patients who had undergone this surgery has been shown to be 41% as against 13% for all Stage III and IV cases randomly taken in this same period (194 cases). Indications for a second-look laparotomy are generally reserved for patients who have responded to chemotherapy after a mean of 6 treatments unless there in an obvious indication to go in. The reasons for this procedure include the idea of assessing completely the state of affairs and if necessary carrying out a large excision operation, knowing full well that the results will depend mainly on the quality of the first treatment given. Survival after second-look laparotomy depends on the mass of neoplastic tissue that is left behind, its size and its position in the peritoneal cavity or in the lumbo-aortic lymph nodes. This makes it possible to define that privileged group of patients that have a good prognosis. These patients who can be cured are those who have no disease in the peritoneal cavity or in the lymph glands. The combination of different ways of treating residual disease in the peritoneum or behind the peritoneum are derived from decisions made following second-look laparotomy. There is no place for radiotherapy of the abdomen and pelvis when there is residual lymph gland disease.