Computed tomography prior to second-look operation in advanced ovarian cancer

Twenty-six patients treated with chemotherapy for ovarian cancer underwent a second-look laparotomy after clinical response (or in the absence of evidence of progressive disease). Abdominopelvic computed tomography (CT) was performed before this operation. Five patients (19%) who had been demonstrated as being free of disease by computed tomography were found to have a tumor larger than 1 cm. Computed tomography sensitivity was good in detection of lymph node metastases (83%), average for pelvic residual tumor (63%) and the omentum (50%), and low for other peritoneal locations (11%). Before second-look operation, the computed tomography scan provides useful surgical information about residual disease in retroperitoneal lymph nodes. However, negative computed tomography findings do not exclude residual tumor or confirm complete remission and therefore cannot replace the second-look laparotomy at this time.