Publication: Advanced epithelial ovarian carcinoma in Thai women: Should we continue to offer second-look laparotomy?
Issued Date
2001-07-01
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ISSN
01252208
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2-s2.0-11244270220
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.84, No.7 (2001), 958-965
Suggested Citation
Vasant Linasmita, Ammarin Thakkinstian, Somsak Tangtrakul, Sunchai Bullangpoti, Sarikapan Wilailak, Somkeart Srisupundit, Nathpong Israngura Advanced epithelial ovarian carcinoma in Thai women: Should we continue to offer second-look laparotomy?. Journal of the Medical Association of Thailand. Vol.84, No.7 (2001), 958-965. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/26748
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Title
Advanced epithelial ovarian carcinoma in Thai women: Should we continue to offer second-look laparotomy?
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Abstract
Objective : To determine survival among patients with epithelial ovarian carcinoma (EOC) who underwent a second-look laparotomy (SLL) and those refusing the procedure. Also to analyze factor(s) influencing the survival of the patients. Method and Material : Medical records were reviewed of patients with advanced EOC who were clinically free of disease after primary surgery and platinum-based chemotherapy between January 1, 1992, and December 31, 1998. All of them were offered SLL. Measurement outcomes include patient survival and disease-free survival. Results : There were 50 patients with clinically complete remission after chemotherapy. Sixteen patients underwent SLL, and thirty-four patients refused the procedure (NSLL). Seven patients (43.8%) were reported to have positive SLL. After the median follow-up time of 35 months, 12 patients had died, and 5 patients were lost to follow-up. The median survival time for patients with SLL was about 60 months. Five-year survival rates of patients in the SLL, and NSLL groups were 37 per cent (95%CI = 7%-69%), and 88 per cent (95%CI = 65%-96%) respectively (P<0.001). The median time to relapse was about 25 months for patients with negative SLL. Five-year disease-free survival rates of patients in the negative SLL, and NSLL groups were 28 per cent (95%CI = 4%-59%), and 54 per cent (95%CI = 34%-70%) respectively (P=0.251). By Cox regression analysis, tumor grade was the only significant prognostic factor influencing patients' survival (HR = 6, 95%CI of HR = 1.2-34.2). Conclusion : The second-look laparotomy doesn't have a favorable impact on overall and disease-free survival. Tumor grade is the only independent prognostic variable for survival of the patients.