Second-look laparotomy; factors affecting the results and the prognosis

Objective: To define the factors which might effect the results of second-l ook laparotomy (SLL) and the prognosis of patients with negative SLL. Methods: Fourteen (42.4%) of the 33 patients who underwent SLL for primary epithelial ovarian cancer had residual disease (positive SLL), while 19 (57 .6%) of them had no evidence of disease(negative SLL); 13 (68.4%) of the 19 patients who were followed without any intervention, still had no evidence of disease, while 6 (31.6%) of them had clinical recurrences. The age of t he patients, histopathological type, stage and grade of the cancers, type o f chemotherapy and the effectiveness of the cytoreductive surgery were pres umed as prognosticators and were compared in each group of patients. Results: The age of the patients, histopathological type of the carcinomas and the type of combined chemorherapy were similar in patients with negativ e or positive SLL and those with recurrences or no evidence of disease duri ng the follow-up after negative SLL (p>0.05). However, the groups of patien ts with negative SLL and those with no evidence of disease during the follo w-up period had lower grade or stage of cancers and less frequent: sub-opti mal cytoreduction than the groups of patients with positive SLL and those w ith recurrences during the follow-up, respectively (p<0.05). Conclusion: SLL could be selectively performed in patients with high grade or high stage ovarian carcinoma or in those patients treated by sub-optimal cytoreduction.