[Clinical study of second-look operation (SLO) for primary ovarian cancer]

The results of second-look operation (SLO) were reviewed in 25 patients with primary ovarian carcinoma and following results were obtained. There were 21 patients in whom SLO was performed to examine whether tumors were present or not. There were 17 patients with negative SLO and remaining four patients were positive SLO. There was a higher tendency for positive SLO with patients of stage III.IV, serous cystoadenocarcinoma, and initial incomplete surgery. It is recommended that SLO is done for the patients with above characteristics. However, there were no cases of positive SLO among patients of stage Ia, so it is suggested that it is not necessary to do SLO. Five years and three years survival of negative SLO were 46% and 68%, respectively and those of positive SLO were 50% and 50%, respectively. Patients with negative SLO were better prognosis than those with positive SLO until four years after SLO. Eight out of 17 patients with negative SLO were recurred. Therefore, some maintenance treatments after negative SLO are needed for attaining further reduction of recurrence, especially patients for serous histology, low grade differentiation, initial incomplete pelvic surgery and stage III.IV. Two out of four patients with positive SLO are alive. Patients with initial complete pelvic surgery and microscopic lesion at SLO tended to be better prognosis. There were four patients in whom tumor debulking was attempted at SLO due to tumor presence after multimodality approach. All patients were eventually recurred and died of disease. However, two patient survived for 44 and 52 months after SLO. It was suggested to be effective for prolongation of life by debulking tumors at SLO.