[The importance of second-look surgery following radio-chemotherapy for advanced ovarian cancer (author's transl)].

Fifteen patients with advanced, initially inoperable ovarian cancer (stages III and IV) were subjected to second-look surgery between May 1976 and August 1979 following combined radio-chemotherapy. Each case had shown a distinct reduction in tumour size and a demarcation of the foreign tissue, which is considered to be prerequisite for second-look surgery. The diagnostic goal of the operation was to verify the success of the preceding radio-chemotherapeutic treatment by means of exact determination of the extent of the residual tumour. The subsequent therapeutic regimen can, if necessary, be modified accordingly. The therapeutic goal is complete surgical removal of the tumour, if at all possible, since the success of subsequent chemotherapy is dependent on the achievement of this aim. The mean interval between initial and second-look surgery was three and a half months. Tumour tissue of varying extent was found in 14 out of 15 cases. In 12 cases total extirpation of the internal genitals was successfully carried out, tumour resection was performed twice, and only one case proved inoperable. The case in question was one of third-look surgery, when after two years of radio-chemotherapy and secondary removal of the internal genitals abdominal tumour recurrence occurred. Two years and six months after initial diagnosis this patient is now undergoing further chemotherapeutic treatment. We believe that this very case illustrates the importance of second-look surgery and of consistent continuation with radio-chemotherapy in cases of advanced inoperable ovarian cancer.