Schneider J, Centeno M M, Montoya F, Rodriguez-Escudero F J
Department of Obstetrics and Gynecology, Hospital de Cruces, Universidad del Pais Vasco, Baracaldo (Vizcaya), Spain.
Eur J Gynaecol Oncol. 1993;14(1):36-9.
Between January 1980 and June 1991, 56 patients with Stage I ovarian carcinoma of different histological varieties were submitted to a second-look laparotomy (SLL) at the University Clinic (Hospital de Cruces) of Bilbao, Spain. The operation was performed upon all patients one year after initial surgery, after completion of adjuvant chemotherapy, or after one year of observation in those cases that were not treated postoperatively. The SLL was negative in 55 of cases and positive in one. The median follow-up after SLL was 59 months. Of the 55 negative cases, four (7.3%) have had a recurrence of their tumor during their long-term follow-up. Three had epithelial tumors and had received complete postoperative chemotherapy, and the fourth was a dysgerminoma. The three patients with epithelial tumors have died under second-line chemotherapy, whereas the dysgerminoma patient is responding well to rescue polychemotherapy. In view of these results, it is useless and probably unethical to perform second-look laparotomy in Stage I ovarian carcinoma if the initial staging was properly performed.
1980年1月至1991年6月期间，西班牙毕尔巴鄂大学诊所（克鲁斯医院）对56例不同组织学类型的I期卵巢癌患者进行了二次探查剖腹术（SLL）。所有患者均在初次手术后一年、辅助化疗完成后或术后未接受治疗的患者观察一年后进行手术。55例患者的二次探查剖腹术结果为阴性，1例为阳性。二次探查剖腹术后的中位随访时间为59个月。在55例阴性病例中，4例（7.3%）在长期随访期间肿瘤复发。3例为上皮性肿瘤，接受了完整的术后化疗，第4例为无性细胞瘤。3例上皮性肿瘤患者在二线化疗期间死亡，而无性细胞瘤患者对挽救性联合化疗反应良好。鉴于这些结果，如果初次分期操作得当，对I期卵巢癌患者进行二次探查剖腹术是无用的，而且可能是不道德的。
