Abstract
During the past two decades, the initial treatment of an advanced ovarian malignancy has been generally uniform: it begins with an exploratory laparotomy surgically to remove as much tumor as possible (1) and to stage the cancer (2). For the 70% of patients classified as stages III and IV, surgery is then followed by combination chemotherapy. Although opinions differ as to the optimal regimen, the standard involves a platinum-based program (3), recently also including paclitaxel (4). A second-look laparotomy is often performed in all patients who achieve a clinical complete remission, that is the inability to detect disease by physical examination and non-invasive laboratory tests. This surgical procedure is able to detect clinical disease not apparent on computerized axial tomography (CT scan), ultrasound, magnetic resonance imaging (MRI), serum CA-125 levels or physical examination (5-7). Major questions, however, have arisen around the need for such a procedure, and whether one can justify it in terms of an improved outcome or merely as an assessment of prognosis (8-14). We shall review: (i) the technique; (ii) the rationale; (iii) the results that have been reported from its routine application; and (iv) controversial issue...Continue Reading
References
Dec 1, 1991·American Journal of Clinical Oncology·D PectasidesA Athanassiou
Sep 1, 1989·Gynecologic Oncology·W J HoskinsW B Jones
Mar 1, 1989·American Journal of Obstetrics and Gynecology·S C RubinJ L Lewis
Mar 1, 1985·Cancer·D M GershensonF N Rutledge
Feb 1, 1988·Radiology·A J MegibowE M Beckman
Jan 1, 1988·Gynecologic Oncology·F B StehmanC E Ehrlich
Jul 1, 1987·Gynecologic Oncology·J A CarmichaelK S Wilson
Feb 1, 1986·Cancer·D S MillerO M Soriero
Jan 1, 1986·Gynecologic Oncology·J M CainJ L Lewis
Feb 7, 1986·JAMA : the Journal of the American Medical Association·D L Clarke-PearsonW T Creasman
May 15, 1985·American Journal of Obstetrics and Gynecology·K C PodratzT A Gaffey
Jul 15, 1985·American Journal of Obstetrics and Gynecology·L R SmirzC E Ehrlich
Nov 1, 1981·Investigative Radiology·N WhitleyJ Whitley
Jun 1, 1994·Gynecologic Oncology·M J CaseyC K Muths
Apr 1, 1993·Seminars in Nuclear Medicine·C E NealJ H Texter
Citations
Feb 14, 1998·Journal of the National Cancer Institute·B D DugganL Dubeau
Oct 12, 1999·Radiographics : a Review Publication of the Radiological Society of North America, Inc·S KawamotoE K Fishman
Sep 9, 2008·Ultrasound Quarterly·Manjiri DigheTheodore Dubinsky
Nov 13, 2003·Expert Opinion on Emerging Drugs·Franco Muggia, M Janice Lu
Apr 23, 2004·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Mory NourianiLouis Dubeau