NEGATIVE 2ND-LOOK LAPAROTOMY - AN OVARIAN -CANCER ANALYSIS OF PROGNOSTIC AND SURVIVAL FACTORS BASED ON 64 CASES TREATED AT THE INSTITUT GUSTAVE-ROUSSY

This study describes 64 cases of ovarian adenocarcinoma seen in the Gu stave-Roussy lnstitut between 1978 and 1988 and who had a negative sec ond-look laparotomy. The median age was 51 years (30-74). FIGO stages were: I: 7 (11%) II: 3 (5%); III: 39 (61%); IV:3 (5%); and undetermine d: 12 (19%). There were 50% of serous type, 14% of endometrioid type, 13% of undifferencied type, 8%, of clear cells type, 3% of mucinous ty pe, and 3% of mixt type tumors There were 50% of grade 3 tumors. Initi al debulking surgery was as complete as possible in 59 patients, with a residual tumor after surgery superior or equal to 2 cm in 25 patient s. Post second-look surgery treatment (n = 57) consisted of chemothera py (CT) alone in 22 patients (34%), radiotherapy (RT) alone in 31 pati ents (49%), and CT associated with RT in 4 patients (6%). Median follo w-up is 100 months. The overall survival rates at 3 and 5 years were r espectively 86 and 81%, and disease free survival rater 70 and 61%. Am ong the 64 patients, 26; relapsed (39%). Median time to relapse was 36 months. There is a statistical difference in the survival between pat ients who had no or inferior to 2 cm residual tumor and others. Residu al tumor was the only factor to be significant in univariate and multi variate analysis of survival.