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Second-Look Laparotomy in the Management of Malignant Germ Cell Tumors of the Ovary

GERSHENSON, DAVID M. MD; COPELAND, LARRY J. MD; DEL JUNCO, GERARD MD; EDWARDS, CREIGHTON L. MD; WHARTON, TAYLOR J. MD; RUTLEDGE, FELIX N. MD
Obstetrics & Gynecology: June 1986
Second-Look Laparotomy in the Management of Malignant Germ Cell Tumors of the Ovary: PDF Only

From 1970 to 1985, 53 patients with malignant nondysgerminomatous germ cell tumors of the ovary underwent second-look laparotomy after initial surgery and combination chemotherapy. Twenty-two patients had immature teratoma, 15 had endodermal sinus tumor, 15 had mixed germ cell tumor, and one patient had embryonal carcinoma. Thirty-one of the neoplasms were stage I, four were stage II, 17 were stage III, and one was stage IV. Two patients received a combination of actinomycin-D, 5-fluorouracil, and cyclophosphamide; four patients received vinblastine, bleomycin, and cisplatin; 44 patients received vincristine, actinomycin-D, and cyclophosphamide; and three patients received a combination of the last two regimens. Second-look findings were negative in 52 patients and positive in one patient who was subsequently salvaged with further chemotherapy. One patient with stage I endodermal sinus tumor relapsed nine months after a negative second-look laparotomy and died. Two patients with negative findings subsequently died of leukemia. Of 53 patients undergoing second-look laparotomy, three are dead (one of cancer and two of leukemia), and 50 patients are surviving without disease. Although the precise role of second-look laparotomy in patients with malignant germ cell tumors is yet to be established, possible indications are discussed.(Obstet Gynecol 67:789, 1986)

© 1986 The American College of Obstetricians and Gynecologists