Results of Second-Look Laparotomy in Advanced Stage Epithelial Ovarian Cancer and Factors Influencing the Results

Objective: The aim of the study was to determine the results of second-look laparotomy (SLL) in patients with stage III C and IV epithelial ovarian cancer and factors influencing the results. Materials and Methods: Medical records of seventy-five patients who underwent SLL between January 1998 and March 2003 were reviewed. The outcome of the SLL procedure and recurrence rates in SLL negative patients were evaluated. The effect of patient age, tumor stage, grade, size, and histological type, presence of ascites, volume of ascites, peritoneal cytology and type of chemotherapy on SLL results were also evaluated. Results: The mean age of the patients was 52 years and mean duration of follow-up was 39 months. In this study, fifty patients received paclitaxel/platinum (six courses) and twenty-five patients received epirubicin/paclitaxel/platinum (six courses) chemotherapy. Of these 75 patients, 47 (62.7%) were SLL negative, 15 (20%) had microscopic residual disease and 13 (17.3%) had gross macroscopic disease. Recurrence occurred in 20 (42.6%) of 47 SLL negative patients. The mean time to recurrence was 14.5 months. The volume of ascites correlated positively with the probability of finding residual tumor at SLL (p<0.05). Patient age, clinical stage, histological type and grade, tumor size, presence of ascites and result of peritoneal cytology were found not to influence the outcome of SLL. Discussion: It is difficult to determine the factors influencing the outcome of SLL because of the insadequacy of the procedure. It is generally considered that SLL doesn't contribute to survival but only gives information about the state of the disease.