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KMID : 0358419920350091366
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Korean Journal of Obstetrics and Gynecology
1992 Volume.35 No. 9 p.1366 ~ p.1372
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Clinical Significance of Second Look Laparotomy in Ovarian Cancer Patients
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김재욱/Kim JU
김동규/성혜리/박찬규/Kim DK/Sung HR/Park CK
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Abstract
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This study was undertaden at the department of Obstetrics and Gynecology, Yonsei University College of Medicine from March 1983 through February 1990. From 165 patients diagnosed as ovarian cancer, we selected 22 patients who had underwent primary laparotomy for staging and reduction of tumor mass followed by planned schedule of chemotherapy and indicated for second look laparotomy. No residual tumor was left behind in all 13 patients of stage I and II whereas tumor mass with diameter greater than 2 cm were left behind in 1 patient in stage III and 2 in stage after primary laparotomy. The complete remission rate after second look laparotomy for stage I and II were 100% at each whereas 57.1% for stage III and 0% for stage Ⅳ. Three cases of positive second look laparotomy were seen from 19 patients with no residual tumor after primary laparotomy. Of these 2 were microscopic and 1 was macroscopic disease. Among three patients with residual tumor after primary laparotomy, 1 showed negative second look laparotomy and 2 showed persistent disease. The prognosis analysed according to the residual tumor size after primary laparotomy revealed 18 out of 19 patients with no residual tumor alive and under current follow up but 1 patient died 9 months after second look laparotomy. Among three patients with residual tumor after primary laparotomy, 1 was alive at 24 months follow up, 1 currently on adjuvant chemotherapy and 1 died 7 months after second look laparotomy. The prognosis was analyzed according to the findings of second look laparotomy where 17 patients with no residual tumor and 3 patients of microscopic and macroscopic disease with diameter less than 2 cm were alive and on current follow-up at period of 4 to 74 months and 2 patients with macroscopic disease, diameter greater than 2 cm died at 7 and 9 months after second look laparotomy respectively. In conclusion, second look laparotomy in early stage ovarian cancer without residual tumor needs to be justified whereas the advanced stage with no residual tumor
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