Role of "third-look" laparotomy in the guidance of ovarian cancer treatment

Larry J. Copeland, J. Taylor Wharton, Felix N. Rutledge, David M. Gershenson, Jan C. Seski, Jay Herson

Research output: Contribution to journalArticle

Abstract

Twenty-seven patients with Stage III epithelial ovarian carcinoma received a "third-look" celiotomy. Each patient received a minimum of an additional 12 courses of chemotherapy after persistent tumor had been documented at a "second-look" procedure. Twelve of the twenty-seven patients have died. No tumor-associated deaths occurred in patients with grade 1 neoplasms. Of the patients with microscopic disease at the second-look procedure who came to third-look laparotomy, none had died secondary to tumor growth. The survival time of patients with microscopic disease at third-look is greater than that of patients with macroscopic disease (P = 0.0009). In patients who had effective tumor reductive surgery performed at second-look, the third-look findings were highly predictive as to survival. Long-term chemotherapy had a significant incidence of related mortality. Four of the twenty-seven patients died as a direct result of the chemotherapeutic toxicity. The patients receiving melphalan for at least 24 courses appeared to be at greatest risk, with 23% dying from either aplastic bone marrow changes or leukemia. The morbidity associated with third-look laparotomy was not excessive. Many factors need careful review prior to planning a third-look laparotomy. This retrospective study demonstrates that patients with either a grade 1 neoplasm or only microscopic disease at the second-look procedure do well regardless of the third-look findings.

Original languageEnglish (US)
Pages (from-to)145-153
Number of pages9
JournalGynecologic Oncology
Volume15
Issue number2
DOIs
StatePublished - Jan 1 1983
Externally publishedYes

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Ovarian Neoplasms
Laparotomy
Therapeutics
Neoplasms
Drug Therapy
Melphalan
Survival
Leukemia
Retrospective Studies
Bone Marrow
Morbidity
Carcinoma
Mortality
Incidence

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Copeland, L. J., Wharton, J. T., Rutledge, F. N., Gershenson, D. M., Seski, J. C., & Herson, J. (1983). Role of "third-look" laparotomy in the guidance of ovarian cancer treatment. Gynecologic Oncology, 15(2), 145-153. https://doi.org/10.1016/0090-8258(83)90068-9

Role of "third-look" laparotomy in the guidance of ovarian cancer treatment. / Copeland, Larry J.; Wharton, J. Taylor; Rutledge, Felix N.; Gershenson, David M.; Seski, Jan C.; Herson, Jay.

In: Gynecologic Oncology, Vol. 15, No. 2, 01.01.1983, p. 145-153.

Research output: Contribution to journalArticle

Copeland, LJ, Wharton, JT, Rutledge, FN, Gershenson, DM, Seski, JC & Herson, J 1983, 'Role of "third-look" laparotomy in the guidance of ovarian cancer treatment', Gynecologic Oncology, vol. 15, no. 2, pp. 145-153. https://doi.org/10.1016/0090-8258(83)90068-9
Copeland, Larry J. ; Wharton, J. Taylor ; Rutledge, Felix N. ; Gershenson, David M. ; Seski, Jan C. ; Herson, Jay. / Role of "third-look" laparotomy in the guidance of ovarian cancer treatment. In: Gynecologic Oncology. 1983 ; Vol. 15, No. 2. pp. 145-153.
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