2ND-LOOK LAPAROTOMY IN THE MANAGEMENT OF FALLOPIAN-TUBE CARCINOMA

Objective. To evaluate the role of second-look laparotomy following pl atinum-based combination chemotherapy in patients with fallopian tube carcinoma. Methods. A retrospective chart review was conducted on 21 p atients with tubal carcinoma who underwent second-look laparotomy foll owing cytoreductive surgery and platinum-based combination chemotherap y. Results. Thirteen patients (62%) were found to be free of disease a t second-look operation. Neither stage nor grade were predictive of fi ndings at second-look procedure. The absence of gross residual disease following primary surgery was the only predictor of disease-free stat us at second-look laparotomy (p<0.01). With a mean follow-up of 49 mon ths among the survivors, four (31%) of the patients with negative seco nd-look laparotomy have had a recurrence. The median survival followin g a positive second-look laparotomy was 18 months (range 5-42 months). Conclusion. Second-look laparotomy provides useful prognostic informa tion in patients with tubal carcinoma. The high rate of recurrent dise ase after negative second-look laparotomy, and the lack of an effectiv e second-line treatment in patients with persistent disease, represent major criticisms of this procedure.