Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Mead, G. M.; Williams, Carmen J.; Macbeth, Fergus; Boyd, I. E.; Whitehouse, J. M. A.

doi:10.1038/bjc.1984.161

Cited by 16 publications

(3 citation statements)

References 16 publications

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“…The differences are, however, not statistically significant. These results are in agreement with recent studies (Mead et al 1984;Cain et al 1986;Podratz er al. 1985;Neijt et al 1984), which also have shown a relation between the small-sized residual tumour at primary surgery and the rate of complete pathological response.…”

Section: Discussionsupporting

confidence: 94%

The prognostic and therapeutic value of second‐look laparotomy in advanced ovarian cancer

Bertelsen

Hansen

Pedersen

et al. 1988

BJOG

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Of 267 patients with ovarian cancer F I G 0 stages I11 and IV, 157 underwent second-look laparotomy after combination chemotherapy consisting of cis-platinum and cyclophosphamide with and without doxorubicin. A t second-look operation 45% had macroscopic tumour, 15% microscopic tumour, and 40% complete pathological response. Survival 3 years after second look was: complete pathological response 74%; microscopic disease 24%; visible tumour <1 cm 28%; visible tumour >1 cm 17%; negative cytology 59%; and positive cytology 18%. Of the patients with macroscopic tumour, 29% had all visible tumour removed at second look. Three-year survival for these patients was about 45%.

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Section: Discussionsupporting

confidence: 94%

The prognostic and therapeutic value of second‐look laparotomy in advanced ovarian cancer

Bertelsen

Hansen

Pedersen

et al. 1988

BJOG

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“…Its role, as suggested by Mead et al (1984), should be solely in the setting up of a clinical trial to define the optimum, minimum chemotherapy or in the assessment of new, or new combinations of, chemotherapeutic agents. The mean duration of hospital stay was 7 days.…”

Section: Side-effectsmentioning

confidence: 99%

“…Apart from these patients second-look laparotomy can give valuable information in relation to prognosis, but unless a new generation of chemotherapeutic agents is devised it has little bearing on patient management or survival for patients who receive initial adequate clearance. Its role, as suggested by Mead et al (1984), should be solely in the setting up of a clinical trial to define the optimum, minimum chemotherapy or in the assessment of new, or new combinations of, chemotherapeutic agents.…”

Section: Side-effectsmentioning

confidence: 99%

The role of second‐look laparotomy in the management of patients with Stage II, III and IV ovarian cancers following chemotherapy with cisplatin, adriamycin and cyclophosphamide

Kirwan¹,

Naftalin²,

Khanna³

et al. 1986

BJOG

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Twenty-eight patients underwent a second-look laparotomy on completing triple agent chemotherapy with cisplatin, adriamycin and cyclophosphamide. The adequacy of the primary debulking procedure and the stage of tumour were the most significant factors associated with a good prognosis. Grade and histological type of tumour had no effect on survival rates. Eighteen patients were surgically free of disease at the second-look procedure and of these, all are alive and disease free with a mean survival time of 39 months. Of the 10 patients with positive second-look procedures, four are dead. The mean survival for patients with positive second look laparotomies was 30.7 months. Second-look laparotomy may contribute to increased survival if pelvic clearance was not attempted at initial staging laparotomy but should primarily be used to assess new agents and new combinations of chemotherapeutic agents and to define the optimum number of courses of chemotherapy. Correspondence: Dr P. H. Kirwan, LectureriSenior Registrar, Department of Obstetrics and Gynaecology, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX. Wallach, R. C. & Blinick, G. (1970) The second-look 198. operation for carcinoma of the ovary. Surg Tepper, E., Sanfilippo, L. J . , Gray, J. & Romney, S. L. (1971) Second look surgery after radiation therapy for advanced stages of cancer of the ovary. Am J Roentg Rad Ther Arch Med 112,755-759. Gynecol Obstet Br 131, 1085-1089.

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Second-look laparotomy in managing epithelial ovarian carcinoma

Dauplat

Ferriere

et al. 1986

Cancer

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Fifty-one patients treated for an epithelial ovarian carcinoma underwent a second-look operation (SLO) from August 1979 to December 1984. Previously, an initial laparotomy had been performed for staging and maximum cytoreductive surgery. This was followed by 6 to 12 courses of combination chemotherapy including cisplatin. Findings at SLO and outcome are discussed as regards extent of initial surgery, preoperative assessment and secondary debulking procedure. In this work, the findings at SLO were often predictable, and related to the adequacy of initial surgery and to a clinical complete response. Nevertheless, after incomplete initial cytoreductive surgery, SLO appears the best procedure to assess the status of the peritoneal cavity and the efficacy of chemotherapy. Negative SLO after incomplete initial surgery assessed a complete response rate of 34% induced by the cisplatin-based chemotherapy. Survival rate of patients with a negative SLO was 93% at 3 years, which demonstrated the highly significant value of SLO in prognosis. Conversely, patient survival with positive findings at SLO was very low, whatever resection can be made. As this work and similar studies by others showed that it could improve patient survival, an attempt should be made to a secondary debulk of residual tumor, and it seems interesting to perform further such secondary resections until definite conclusions can be drawn about this procedure.

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Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Cited by 16 publications

References 16 publications

The prognostic and therapeutic value of second‐look laparotomy in advanced ovarian cancer

The prognostic and therapeutic value of second‐look laparotomy in advanced ovarian cancer

The role of second‐look laparotomy in the management of patients with Stage II, III and IV ovarian cancers following chemotherapy with cisplatin, adriamycin and cyclophosphamide

Second-look laparotomy in managing epithelial ovarian carcinoma

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