[Second-look laparotomy in epithelial ovarian cancer: an evaluation of 23 cases]

Between 1981-1988, 23 patients with epithelial ovarian cancer underwent second-look laparotomy after initial surgery followed by multiple courses of chemotherapy. There was no evidence of tumor before operation. Six patients (26%) had gross tumor and 5 (22%) had microscopic tumor. One of 3 patients with stage I or II and 50% (10/20) of patients with stage III and recurrent disease had positive second-look. Two of 7 (29%) patients with no residual tumor after initial surgery and 9 of 16 (56%) with residual tumor had positive second-look. It showed that the results of second-look were correlated with stage and residual tumor left after initial surgery. Sixteen patients had CA125 serum immunoassay prior to second-look. CA125 level was in normal limits (less than or equal to 65 U/ml) in 12 patients. Positive second-look findings were observed in 7 patients (58%), of which 5 had microscopic tumors. The results indicate that the second-look laparotomy is probably the best way to evaluate residual tumor in the abdominal cavity.