Second-look laparotomy in advanced ovarian cancer: A critical assessment of morbidity and impact on survival

Abstract

Background: The routine inclusion of second-look laparotomy in the management of patients with epithelial ovarian cancer is controversial. At issue is the justification of morbidity incumbent upon surgery and the possible survival benefit of secondary cytoreduction. Methods: The rate of major complications of surgery was assessed among 100 consecutive patients with FIGO stage III or IV epithelial ovarian cancer who underwent second-look laparotomy. All patients demonstrated a complete clinical and biochemical (CA125 Results: Thirteen patients (13%) had 15 major complications at surgery. Comparison of the complication rates for patients in groups 1, 2, and 3, of 10%, 8.5%, and 21.4%, respectively, did not achieve statistical significance (p=0.228). The estimated 5-year survival for patients in groups 1, 2, and 3 of 63.9%, 39.8%, and 14.2%, did differ significantly (pConclusion: The major complication rate associated with second-look laparotomy is not prohibitive Secondary cytoreductive efforts may result in improved survival for patients with epithelial ovarian cancer.