Second-look Laparoscopy in Patients with Ovarian Cancer

  • Jan Decloedt
  • Ignace Vergote


The former widely accepted management for patients with epithelial ovarian cancer consisted of three basic components: (1) initial surgery with complete, thorough staging and debulking of advanced disease; (2) combination platinum-based chemotherapy; and (3) surgical reassessment to determine response to initial therapy.1 The role of primary debulking surgery in some subgroups of patients with advanced ovarian carcinoma has been questioned in recent years.2–5 Second-look surgery for ovarian carcinoma has been abandoned in most centres, because of the lack of a good second-line therapy that might increase overall survival. Intraperitoneal radioactive phosphorus as consolidating therapy in patients with negative second-look laparotomy was associated with a considerable number of bowel complications, without improving the overall survival.6


Phosphorus Cisplatinum Oncol Doxorubicin Cyclophosphamide 


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  1. 1.
    Rubin SC (1993) Second-look laparotomy in ovarian cancer. In: Markman M, Hoskins WJ (eds) Cancer of the ovary, 1st edn. Raven Press, New York, pp 175–185Google Scholar
  2. 2.
    Hunter RW, Alexander ND, Souffer WP (1992) Meta-analysis of surgery in advanced ovarian carcinoma: is a maximum cytoreductive surgery an independent determinant of prognosis? Am J Obstet Gynecol 166:504–511PubMedGoogle Scholar
  3. 3.
    Potter ME, Partridge EE, Hatch KD et al (1991) Primary surgical therapy of ovarian cancer: how much and when? Gynecol Oncol 40:195–200PubMedCrossRefGoogle Scholar
  4. 4.
    Hoskins WJ, Buncy BN, Thigpen JT et al (1992) The influence of cytoreductive surgery on recurrence-free interval and survival in small volume Stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. Gynecol Oncol 47:159–166PubMedCrossRefGoogle Scholar
  5. 5.
    Vergote IB, De Wever I (1997) Primäre Zytoreduktive Operation bei Ovarialkarzinom im gortgeschittenen Stadium. Ist sie bei alien Patientinnen erforderlich? Gynäkologe 30:102–107CrossRefGoogle Scholar
  6. 6.
    Vergote I, Winderen M, De Vos L et al (1993) Intraperitoneal radioactive phosphorus therapy in epithelial ovarian cancer. Analysis of benefits and complications in 313 patients treated primarily or at second-look laparotomy. Cancer 71 (7):2250–2260PubMedCrossRefGoogle Scholar
  7. 7.
    Wangensteen OH (1949) Cancer of the colon and rectum. Wes Med J 48:591–597Google Scholar
  8. 8.
    Wangensteen OH, Lewis FJ, Tovgen LA (1951) The “second- look” in cancer surgery, Lancet 71:303–307Google Scholar
  9. 9.
    Reuter KL, Griffin T, Richard E (1989) Comparison of abdominal computed tomography results and findings at second-look laparotomy in ovarian carcinoma. Cancer 63:1123–1128PubMedCrossRefGoogle Scholar
  10. 10.
    Lele S, Piver MS (1986) Interval laparoscopy prior to second- look laparotomy in ovarian cancer. Obstet Gynecol 68:345–349PubMedGoogle Scholar
  11. 11.
    Rosenoff SH, De Vita VT, Hubbard S (1975) Peritoneoscopy in the staging and follow-up of ovarian cancer. Semin Oncol 2:223–228PubMedGoogle Scholar
  12. 12.
    Smith WG, Day TG, Smith JP (1977) The use of laparoscopy to determine the results of chemotherapy for ovarian cancer. J Reprod Med 18:257–260PubMedGoogle Scholar
  13. 13.
    Mangioni C, Bolis G, Molteni P (1979) Indications, advantages and limits of laparoscopy in ovarian cancer. Gynecol Oncol 7:47–55PubMedCrossRefGoogle Scholar
  14. 14.
    Piver MS, Shashikant BL, Barlow JJ (1980) Second-look laparoscopy prior to proposed second-look laparotomy. Obstet Gynecol 55:571–573PubMedGoogle Scholar
  15. 15.
    Berek JS, Griffith CT, Leventhal JM (1981) Laparoscopy for second-look evaluation in ovarian cancer. Obstet Gynecol 58:192–198PubMedGoogle Scholar
  16. 16.
    Quinn MA, Bishop GJ, Campbell JJ et al (1980) Laparoscopic follow-up of patients with ovarian cancer. Br J Obstet Gynecol 87:1132–1139CrossRefGoogle Scholar
  17. 17.
    Nicoletto MO, Tumolo S, Talami R et al (1997) Surgical second-look in ovarian cancer: a randomized study in patients with laparoscopic complete remission - a Northeastern Oncology Cooperative Group-Ovarian Cancer Cooperative Group study. J Clin Oncol 15:994–999PubMedGoogle Scholar
  18. 18.
    Abu-Rustum NR, Barakat RR, Siegel PL et al (1996) Second- look operation for epithelial ovarian cancer: laparoscopy or laparotomy? Obstet Gynecol 88:549–553PubMedCrossRefGoogle Scholar
  19. 19.
    Fiorentino M, Brigato G, Cima G et al (1993) Randomized study of redebulking in epithelial ovarian cancer (abstract). Proc Am Soc Clin Oncol 12:267Google Scholar
  20. 20.
    Van Dam P, Decloedt J, Tjalma W et al (1997) Diagnostic laparoscopy to assess operability of advanced ovarian cancer: a feasibility study. In: De Oliveira CF, Oliveira HM (eds) Proceedings of the 10th International Meeting of Gynecologic Oncology. Monduzzi Editore, Bologna, pp 259-266Google Scholar
  21. 21.
    Janisch H, Schieder K, Koelbl H (1989) Diagnostic versus therapeutic second-look surgery in patients with ovarian cancer. Baillieres Clin Obstet Gynecol 3:191–200CrossRefGoogle Scholar
  22. 22.
    Decloedt J, Berteloot P, Vergote I (1997) The feasibility of open laparoscopy in gynecologic-oncologic patients. Gynecol Oncol 66:138–140PubMedCrossRefGoogle Scholar

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© Springer-Verlag London Limited 2003

Authors and Affiliations

  • Jan Decloedt
  • Ignace Vergote

There are no affiliations available

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