Ovarian carcinoma; second-look laparotomy postchemotherapy

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The proper staging and extent of disease in carcinoma of the ovary cannot be determined without an exploratory laparotomy.1 In some cases, reexploration after an interval of treatment helps the physician to determine whether the therapy has been successful. Exploratory laparotomy for this purpose, or second-look operation, has become a common practice at the Cleveland Clinic. With this ongoing evaluation new treatment schedules will be designed and others modified.

Advanced ovarian cancer should be treated surgically when diagnosed. In many cases radical resection is accomplished with total removal of all known cancer.2 In other cases as much cancer is removed as possible to decrease the tumor cell population.3 In either case chemotherapy is used postoperatively.

In 1951, Wangensteen et al4 reported the second-look operation for patients with cancer of the colon. With the development of new chemotherapeutic agents and combinations of these agents, second-look operations are performed on advanced ovarian cancer at this institution.

Twenty-two patients with advanced cancer of the ovary, on whom second-look operation was performed after chemotherapy are the subjects of this study. When no tumor was found in several biopsy specimens and results of peritoneal cytologic studies were negative, chemotherapy was discontinued. Patients with residual disease continued to receive chemotherapy. One patient received P32 intraperitoneally.

Patients and methods

Sixty-two patients have been treated for advanced ovarian cancer in the Cleveland Clinic Gynecologic Oncology Section. Advanced ovarian cancer includes Stage IIB or greater according to the International Federation of Gynecologists and Obstetricians (FIGO) staging system. These patients . . .



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