The use of laparoscopy to determine the results of chemotherapy for ovarian cancer.

The chemotherapeutic management of patients with epithelial tumors of the ovary is hampered by a lack of diagnostic tests that are sufficiently sensitive for detecting residual or recurrent tumor. At the completion of a chemotherapy program, direct visualization of the peritoneal cavity is necessary to accurately assess the amount and location of residual tumor. Laparoscopy, with visually directed biopsies of residual tumor masses, can spare some patients a laparotomy and yet provide a safe and easy route for assessment of intraabdominal disease. If residual tumor is not seen at laparoscopy, than laparotomy with multiple peritoneal biopsies must be done so that residual tumor will not be missed and chemotherapy prematurely stopped. Laparoscopy is not an alternative to "second look" laparotomy but is a useful adjunct for determining the presence of resectable, unresectable or diffuse disease after chemotherapy.