Predictors and outcomes of recurrent disease after a negative second look laparotomy.

BACKGROUND AND

OBJECTIVES

To analyze the predictors and outcomes of recurrent disease in patients with epithelial ovarian carcinoma (EOC) after a negative second look laparotomy (SLL).

METHODS

One hundred nine EOC patients with a negative SLL treated at Hacettepe Hospital were retrospectively analyzed.

RESULTS

Of these patients, 70 (64.2%) had no evidence of disease during follow up while remaining 39 (35.8%) had recurrence. Majority of the recurrences (82.1%) were detected within the initial 2 years of the SLL procedure. Multivariate analysis revealed stage and grade of the disease to be the significant predictors for the recurrent disease (P < 0.01 and P = 0.025, respectively). A second analysis with respect to initial metastatic sites revealed omental metastatis was significantly associated with recurrent disease (P < 0.001). Survival of patients with a recurrent disease was significantly poorer and dropped abruptly once a recurrence is developed.

CONCLUSIONS

Patients with initial omental metastasis, advanced stage and high grade tumors have highest risk for developing recurrences after a (-) SLL. Most of the recurrences develop during the initial 2 years following the (-) SLL and survival drops to less than 2 years once a recurrence is found.