Second-look laparotomy in fallopian tube carcinoma

From August 1974 through August 1980, eight patients with primary fallopian tube carcinoma underwent second-look laparotomies at The University of Texas M.D. Anderson Hospital and Tumor Institute. Prior to the second-look laparotomies all patients were clinically free of disease. Initial treatment consisted of surgery and chemotherapy for four of these patients, surgery and radiation therapy for two patients, and surgery, radiation therapy, and chemotherapy for two patients. The second-look laparotomies showed five patients were free of disease, one patient had microscopic residual disease, and two patients had persistent macroscopic disease. Recurrences following negative second-look laparotomies developed in two patients. One recurrence occurred at 41 months after the procedure and the other 69 months afterward. Both patients lived more than 5 years after the second-look laparotomies were performed. Three patients with negative findings at second-look procedures and the patient with microscopic residual disease remain clinically free of disease 34, 53, 74, and 50 months after the laparotomies, respectively. Following additional chemotherapy, the two patients who evidenced macroscopic disease at the second-look procedure died 16 and 32 months following the second-look laparotomies. The second-look findings can be used to predict disease behavior and may have a role in the management of patients with fallopian tube carcinoma.