The role of second-look surgery was to assess the completeness of response and resect any residual tumor after the completion of initial chemotherapy in patients with advanced epithelial ovarian cancer. Initial enthusiasm for the procedure has been tempered by its lack of efficacy. GOG examined the role of second-look surgery as part of its GOG 158 trial. Patients were asked to choose whether they wanted to undergo second-look surgery after completing chemotherapy. The patients who received second-look surgery showed no improvement in progression-free or overall survival when compared with the group of patients who did not39 (Fig. 7-20). Obermair and Sevelda40 analyzed their group's experience with secondary cytoreduc-tive surgery at the time of second-look laparotomy. There was no significant survival difference when those debulked to no residual disease were compared with women debulked to less than 2 cm or more than 2 cm residual disease. Nevertheless, second-look surgery continues to be the most accurate means of documenting the response to chemotherapy and providing prognostic information.
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