Creasman W T
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston 29425.
Gynecol Oncol. 1994 Dec;55(3 Pt 2):S122-7. doi: 10.1006/gyno.1994.1350.
The role of the second-look laparotomy has become standard management in the patients with ovarian cancer without any objective evidence that it has a major impact on survival. In patients with early-stage disease, data on second-look surgery would suggest that there is very little, if any, benefit in patients who have had optimal full surgical staging and appropriate postoperative therapy. In advanced disease, even if the second-look laparotomy is negative, one-half will develop a recurrence. The role of the second-look laparotomy as a secondary debulking procedure has been suggested by some but appears to be beneficial in only a small subset of patients--less than 10%. In patients being treated on protocol, a second-look laparotomy has become the gold standard for determining effectiveness of a specific treatment being evaluated and would tend to be justified in this group to increase our knowledge and hopefully arrive at a better postsurgical therapy.
二次剖腹探查术在卵巢癌患者的治疗中已成为标准治疗手段，但并无客观证据表明其对生存率有重大影响。对于早期疾病患者，二次剖腹探查术的数据显示，那些已经接受了最佳全面手术分期和适当术后治疗的患者，即便有获益，也是微乎其微。在晚期疾病中，即使二次剖腹探查术结果为阴性，仍有一半患者会复发。一些人认为二次剖腹探查术可作为二次减瘤手术，但似乎仅对不到10%的一小部分患者有益。对于按方案接受治疗的患者，二次剖腹探查术已成为确定所评估特定治疗有效性的金标准，在这组患者中进行该手术往往是合理的，有助于增加我们的认识，并有望找到更好的术后治疗方法。
