Ovarian cancer recurrences in patients with no macroscopic tumor at second-look laparotomy

Second-look laparotomy has been relied upon extensively to guide the treatment of ovarian cancer. Among patients with other than well-differentiated primary tumors, the recurrence rate approximates 50% for patients with either negative or microscopically positive findings at second-look laparotomy. Although patients with persistent microscopic disease have received additional therapy, the patients with negative findings have not. The risk of recurrence seems high enough to consider adjuvant therapy for patients with negative findings at second-look laparotomy. However, since half of the patients remain disease free for an extended interval, and in view of the potential toxicity, any adjuvant treatment should be carried out by strict investigational protocol.