Data on 304 patients with ovarian malignancies (mostly epithelial-72.0%) who had undergone second-look surgery were analysed to develop indications and assess the clinical value of the procedure. Second-look operations were performed 10-22 months after primary surgery in the following clinical settings: (1) clinical remission if wash-offs from the Douglas' pouch peritoneum revealed tumor cells or a high blood-CA-125 level was established (8 patients with stage I-II cancer), (2) remission after 6-10 courses of combination chemotherapy (13 patients with stage III-IV tumor), (3) remission following non-radical primary surgery (117 cases), (4) patients with suspected relapse (144), and (5) cases who were not suspicious for relapse but required laparotomy for concomitant surgical pathology such as, for instance, ventral hernia (22). Intra- and postoperative complications were encountered in 29 out of 304 (9.5%) patients and operative lethality rate was 0.9%. It was shown that improvement in noninvasive methods of monitoring allows to limit indications for second-look surgery in stage III cancer.
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