Second-look operations in the planned management of advanced ovarian carcinoma

Raju, K. S.; McKinna, J A; Barker, Graham; Wiltshaw, E.; Jones, Judy

doi:10.1016/0002-9378(82)90432-x

Cited by 68 publications

(16 citation statements)

References 9 publications

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“…A striking relationship was found between the number of cycles of chemotherapy given prior to second look surgery, and the incidence of residual disease found at surgery (14.6% negative second look after 2-9 courses of melphalan; 43.7% for > 10 courses of melphalan). (Young et al, 1978;Oldham et al, 1982;Raju et al, 1982 A relatively common result of these procedures, not alluded to in the literature was that the findings were equivocal at surgery; many patients with initial gross tumour were found to have dense abdominal and/or pelvic adhesions with poor planes of cleavage and surgery proved technically difficult. Despite negative biopsies, relapse occurred in 4 of 5 such patients and close follow up is clearly mandatory.…”

Section: Resultsmentioning

confidence: 99%

“…More recently, and with the advent of combination chemotherapy, second look surgery (laparoscopy or laparotomy) has been used earlier in the clinical course, to date the time of complete remission and thereby decide the number of cycles of chemotherapy that need to be given (Young et al, 1978;Ozols et al, 1981;Oldham et al, 1982;Raju et al, 1982). There is, however, no evidence to suggest that survival can be increased by use of these techniques, and in addition only scanty evidence exists that combination chemotherapy produces survival that is superior to single agents (Young et al, 1978;Katz et al, 1981;Pereira et al, 1981;Sturgeon et al, 1982;Carmo-Pereira et al, 1982;Vogl et al, 1982;Omura et al, 1983).…”

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confidence: 99%

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Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Mead¹,

Williams²,

Macbeth³

et al. 1984

Br J Cancer

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Summary Case histories from 20 patients undergoing postchemotherapy "second look" laparotomy for metastatic epithelial cell carcinoma of the ovary were reviewed in an attempt to evaluate the usefulness of this procedure and its likely impact on patient survival. The patient population comprised 18 patients treated with a combination of cisplatin, adriamycin and cyclophosphamide (PACe) and 2 patients treated with chlorambucil. The findings at second look were often predictable, and related to the adequacy of initial surgery. Complete tumour regression identified a group of patients with a relatively good prognosis. However in most patients residual tumour was found which rarely proved resectable. Second line chemotherapy was poorly tolerated, and appeared to have little impact on the disease particulary after combination chemotherapy had been used initially.There was little evidence that second look surgery itself positively contributed to survival. This procedure and its timing should be regarded as experimental and a suitable subject for randomised clinical trials.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Mead¹,

Williams²,

Macbeth³

et al. 1984

Br J Cancer

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“…2). Aus diesem Grund ergibt sich bei Patientinnen mit einer Progression oder einem No-changeVerhalten des Tumors unter der Chemotherapie keine Indika tion für eine Second-look-Operation [19,20,25,29]. Ist die klinische Beurteilung unsicher, so kann der Second-look mit der Open-Laparoskopie begonnen werden.…”

Section: Operatives Vorgehen Bei Der Second-look-operationunclassified

Kontrolle des Ansprechens von Ovarialkarzinomen auf die zytostatische Therapie und Stellenwert der Second-look-Operation

Teufel¹,

Meerpohl²,

Pfleiderer³

1985

Oncol Res Treat

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Im vorliegenden wird der Wert der Second-look-Operation (SLO) nach den Erfahrungen an 121 Patientinnen mit Ovarialkarzinom der Stadien III und IV zwischen 1979 und 1983 diskutiert. Insgesamt wurde bei 58% der Patientinnen ein solcher Eingriff durchgeführt. Wurde nach der Chemotherapie klinisch kein Tumor mehr angenommen (n = 33), traf dieses nach der SLO nur bei 19 Fallen zu. Bei Teilremissionen war die präoperative Diagnose in 14 von 21 Fallen und bei NC in 4 von 9 Fallen zutreffend. Der Progreß wurde klinisch immer sicher diagnostiziert. Eine zusätzliche Entfernung von Resttumorgewebe gelang in 7 von 49 Fallen (14%). Sie ist überhaupt nur bei kleinem Tumorrest möglich. Eine Verbesserung der Prognose tritt nicht ein. Aussagen über die Wahl des richtigen Zeitpunktes zur SLO und zum Sinn einer sekundären Tumorresektion können noch nicht gemacht werden.

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“…Moreover, it still remains to be established whether repetitive laparotomies with 'salvage' surgical debulking are of benefit to the patient [4], Noninvasive diagnostic procedures allowing eva luation of response to treatment and detection of minimal residual disease are therefore needed.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Ovarian Cancer Antigen, CA-125, as a Tumor Marker

Onetto¹,

Bruzzone²,

Conte³

et al. 1989

Oncology

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The presence of the Ca-125 antigen was tested in the serum of 46 patients with ovarian cancer in order to determine the prognostic value of preoperative levels and its usefulness for monitoring the clinical response in longitudinal studies; survival (S) and progression-free survival (PFS) were also evaluated. In our series, the specificity of the assay in normal subjects and in patients with benign gynecological diseases is 99.3 and 73.2% respectively, and the sensitivity is 91.9%. Preoperative Ca-125 levels are not correlated with S and PFS, whereas an advantage in S and PFS is clearly shown for patients in whom the marker level decreases after treatment. Serial determinations of Ca-125 serum levels provide a reliable test to assess response to therapy and to predict disease progression.

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Second-look operations in the planned management of advanced ovarian carcinoma

Cited by 68 publications

References 9 publications

Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Kontrolle des Ansprechens von Ovarialkarzinomen auf die zytostatische Therapie und Stellenwert der Second-look-Operation

Evaluation of the Ovarian Cancer Antigen, CA-125, as a Tumor Marker

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