COMPUTED-TOMOGRAPHY PRIOR TO 2ND-LOOK OPERATION IN ADVANCED OVARIAN-CANCER

Abstract

Patients (26) treated with chemotherapy for ovarian cancer underwent a 2nd-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 CT were found to have a tumor > 1 cm. CT 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 2nd-look operation, the CT scan provides useful surgical information about residual disease in retroperitoneal lymph nodes. However, negative-CT findings do not exclude residual tumor or confirm complete remission and, therefore, cannot replace the 2nd-look laparotomy at this time.