[The second-look operation in advanced ovarian cancer]

In cases of progressive, primary palliatively operated ovarian carcinoma or of such with unresectable tumors (stage III and IV) antineoplastic chemotherapy is preferred. Second-look laparotomy with the aim of radical operation is indicated in cases of established tumor remission. In our clinic 37 second-look operations were carried out in the period between 1975 and 1982, in 30 cases (81%) a secondary radical operation was possible. 56.8% of the patients were relaparotomised 2 to 5 months after the first operation, 13.5% after 6 to 9 months and 29.7% not before more than 10 months after the first operation. The average age was 51.4 years. Clinically established tumor remission (CR = 14, PR = 17) was proven intraoperatively in 31 women (83.8%). In 6 cases of them (16.2%) there existed no more tumor from a histological viewpoint, and in three cases (8.1%) tumor structures could be proven only by means of a microscope. Prior to this all patients had undergone a combined chemotherapy by CPM, MTX, 5-FU and VBL, 8 women (21.6%) underwent an additional loco-regional chemotherapy by 5-FU and MTX. The 5-years survival rate amounts to 50.2%. After remission the average survival amounts to 39.8 months, otherwise it is only 14 months. This is significantly prolonged in cases of secondary operations after more than 10 months.