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The second-look operation improves survival in suboptimally debulked stage III ovarian cancer patients
  1. J. Rahaman,
  2. P. Dottino,
  3. T. S. Jennings,
  4. J. Holland and
  5. C. J. Cohen
  1. The Mount Sinai Medical Center, New York, NY
  1. Address correspondence and reprint requests to: Jamal Rahaman, MD, Division of Gynecologic Oncology, The Mount Sinai Medical Center, 1176 Fifth Avenue, Box 1173, New York, NY 10029, USA. Email: jamal.rahaman{at}


In a single-institution retrospective cohort study, 230 patients were treated for stage III primary ovarian cancer and 175 became eligible for second-look operations by virtue of a complete clinical response after primary surgical cytoreduction and platinum-based combination chemotherapy. Of these, 109 underwent a second-look operation. Optimal primary cytoreduction was defined as residual disease ≤1 cm. Median follow-up was 68.3 months. Five-year survival for all the 230 stage III ovarian cancers was 43.4%. Among all eligible patients (n = 175), there was no survival difference (P = 0.67) in those having second look (57.3%, 5-year survival) versus no second look (48.7%). In those patients with optimal primary cytoreduction (n = 118), there was no survival advantage to second look (69% versus 61%, P = 0.7). However, in those with suboptimal primary cytoreduction (n = 47), 5-year survival was 36% in those having second look versus only 13% in those refusing second look (P < 0.05). Multivariate analysis identified second-look surgery as the only significant independent prognostic variable affecting survival (RR = 0.321, P < 0.04). Patients with suboptimal debulking at primary surgery for stage III ovarian cancer appear to achieve a survival benefit from second-look surgical procedures, presumably from the early identification and treatment of residual disease.

  • ovarian cancer survival
  • second-look surgery
  • suboptimal cytoreduction

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