Optimal timing of a second-look operation for advanced epithelial ovarian cancer

To clarify the optimal timing of second look operation (SLO) for advanced ovarian cancer, we retrospectively reviewed the records of 53 patients with FIGO stage 2, 3 and 4 epithelial ovarian cancer. SLOs were performed more than 12 months after primary surgery in 35 patients (late SLOs), and immediately after first-line chemotherapy in 18 patients (early SLOs). We examined data on SLO findings and patients' clinical courses. SLO findings were positive 5 (27.7%) of 18 in the early SLO group and in 11 (31.4%) of 35 in late SLO group. Positive findings were detected by washing cytology in 3 (60%) of the 5 in the early SLO group compared with 2 (18.2%) of the 11 in the late SLO group. Patients with microscopic disease had better prognosis than patients with macro lesions. False-negative SLO findings were 30.8% in the early SLO group and 12.5% in the late SLO group. All patients who recurred after negative SLOs had grade 2 and 3 tumors. The benefits of SLO were limited to accurate evaluation of first-line chemotherapy and early detection of persistent disease. In these implications, early performance of SLO is recommended.