Second-look operations in the planned management of advanced ovarian carcinoma.

Second-look operations were done in 65 patients as part of a planned management program of advanced ovarian cancer. All patients received chemotherapy with cisplatin, and only those who had a good clinical regression after an incomplete initial surgical procedure were subjected to a second operation. At second-look operations, 16 patients (25%) had no macroscopic tumor (surgical complete remission), and these patients have a 72% probability of surviving 5 years. In 49 patients (75%), considerable regression had occurred but macroscopic disease was still present. Incomplete or complete removal of residual disease was possible in 38 cases (58%), but survival curves suggest that removal of all macroscopic residual disease at second-look operations did not improve survival expectancy. In the other 11 cases (17%), although there was slight improvement in the extent of disease, further surgical resection was not possible and the survival expectancy in these cases was very poor.