Although second-look laparotomy(SLL) remains the hallmark method for determining disease status and reduction of tumor volume after adjuvant chemotherapy, the inclusion of reassessment surgery and repeated cytoreductive surgery in the treatment
schedule
of ovarian carcinoma has been challenged. Especially the role of SLL for the benefits of survival is controversal. So we analyzed variable prognostic factors including FIGO stage, cell type, tumor grade and residual tumor after SLL. Between May
1986 and
December 1992, thirty eight patients with epithelial ovarian ovarian carcinoma identified as clinical remission after initial surgery and postoperative chemotherapy underwent second-look laparotomy at the Korean Cancer Center Hospital in Korea.
Thirty
patients(78.9%) had no evidence of residual tumor and eight patients(21.1%)had residual tumor. With a mean follow-up 39 months, the 3 year survival rate of these patients was 86.7%. Univariate revealed four covariates that were statistically
significant
in predicting continued disease free status. These factors were FIGO stage(p=0.00253), residual mass after primary laparotomy(P=0.0010), preoperative serum CA-125 elevation before SLL(p=0.0093) and residual mass after SLL(p=0.0404). But in
multivariate
analysis, residual tumor after SLL was not independent prognostic factor. The relative risks of other independent prognostic factors were 7.6 in residual tumor after primary surgery, 6.6 in FIGO stage, 3.7 in preoperative elevated serum CA-125
before
SLL.
We concluded that residual mass after SLL is not independent prgnostic factor. And SLL cannot be considered a valuable routine procedure. But SLL may have a role in evaluating the efficacy of a postoperative second line treatment.
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