Second-look operations in ovarian cancer.

One hundred eighty-six patients with epithelial tumors of the ovary who were managed at the M. D. Anderson Hospital and Tumor Institute underwent an exploratory operation ("second-look" operation) to assess the status of the cancer. Fifty-eight patients were found to have no evidence of disease (NED) and chemotherapy was discontinued. Eight patients with advanced ovarian cancer had NED 5 or more years after negative second-look operations and were probably cured by chemotherapy. Seven patients who were found to have cancer at second-look operations had a change in management as a result of the operation and had NED 5 or more years later. The most important factors correlating with negative second-look operations were the stage of cancer, the amount of residual tumor left at the initial operation, and the number of courses of chemotherapy administered prior to the second-look operation. Survival after positive second-look operations varied directly with the volume of tumor found at the time of operation and the amount of tumor left behind at the second-look operation. Patients who were treated with radiation therapy had a poorer survival rate than those who were treated with chemotherapy after positive second-look operations.