ABSTRACT
The role of second-look surgery in ovarian cancer has evolved as a result of improved operative technology and treatment outcome. The original intent of the procedure was its therapeutic effect in the era when treatment of ovarian cancer was limited to surgery. Second-look surgery was subsequently used to determine treatment duration following the discovery that ovarian cancer could be successfully treated with chemotherapy. Currently, the debate over the secondlook procedure centers around the value of its prognostic information balanced against the lack of a demonstrated impact on survival. While a small subset of patients derive a therapeutic benefit from secondary cytoreduction at the time of the second-look procedure, second-look surgical assessment has not clearly altered the outcome of most patients. Retrospective reports of patient outcome after second-look surgery suffer from inconsistent study design that often fails to utilize the findings of second-look surgery to determine subsequent therapy. Recent advances in laparoscopic technique have fueled the debate because of the comparative ease and high patient acceptance of a laparoscopic second-look procedure.
