A critical reassessment of second-look laparotomy in epithelial ovarian carcinoma

D. S. Miller, S. C. Ballon, N. N H Teng, D. B. Seifer, O. M. Soriero

Research output: Contribution to journalArticle

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Abstract

Eighty-eight women with epithelial ovarian carcinoma, treated by first-line chemotherapy, achieved a complete clinical response and underwent second-look laparotomy to assess the true pathologic status of their disease. Persistent tumor was found in 50 patients (57%). Thirty-two of these (36%) had obvious gross tumor, whereas, 16 (18%) had microscopic disease. Thirty-eight patients (43%) had no pathologic evidence of persistent ovarian carcinoma. With a follow-up of 6 to 60 months, 30 of these patients (79%) remain without evidence of recurrence. Multivariate logistic regression analysis revealed three covariates that were independently significant in predicting continued disease-free status. These included: the greatest diameter of the largest residual tumor left at the primary operation; histologic features of the tumor; and the diameter of the largest tumor aggregated found at initial operation. A mathematical model based on the most significant covariates was designed to assess the relative risk of any patient having persistent tumor at second-look laparotomy. A comparison of the predicted to actual outcome revealed a sensitivity of the model of 88%, a specificity of 71%, and an accuracy of 77%. Second-look laparotomy represents the basis on which potentially curative second-line salvage therapy can be initiated. With an increasing period of follow-up and with greater numbers of patients, it can potentially document a complete pathologic response to first-line therapy administered with curative intent, and identify patients for additional, adjunctive therapy, who are at risk of recurrence.

Original languageEnglish (US)
Pages (from-to)530-535
Number of pages6
JournalCancer
Volume57
Issue number3
DOIs
StatePublished - 1986

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Laparotomy
Carcinoma
Neoplasms
Recurrence
Salvage Therapy
Residual Neoplasm
Theoretical Models
Logistic Models
Regression Analysis
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

A critical reassessment of second-look laparotomy in epithelial ovarian carcinoma. / Miller, D. S.; Ballon, S. C.; Teng, N. N H; Seifer, D. B.; Soriero, O. M.

In: Cancer, Vol. 57, No. 3, 1986, p. 530-535.

Research output: Contribution to journalArticle

Miller, D. S. ; Ballon, S. C. ; Teng, N. N H ; Seifer, D. B. ; Soriero, O. M. / A critical reassessment of second-look laparotomy in epithelial ovarian carcinoma. In: Cancer. 1986 ; Vol. 57, No. 3. pp. 530-535.
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