[The management of ovarian adenocarcinoma. "Second look" surgical operation after chemotherapy (author's transl)].

Forty patients with adenocarcinoma of the ovary (including 34 in stages III and IV) underwent a "second look" surgical operation after a first course of chemotherapy. The operation, which carried negligible morbidity, demonstrated complete remission in 27,5% of the cases; whenever necessary and possible achieved complete remission by surgical excision; and helped in establishing a second course of chemotherapy or chemo-immunotherapy. This therapeutic strategy seems to have had overall favourable repercussions on the patients' short- and mid-term survical. Long-term results cannot yet be assessed, but the knowledge of late failures suggests that applying intensive chemotherapy or, preferably, chemo-immunotherapy after the "second look", or even reserving potent cytostatic drugs for that period, could be beneficial. From the very favourable survival rate in patients found on second look to have complete remission, one may conclude that surgically confirmed remission should be considered as the primary target of the initial treatment.