Prognostic factors for outcome of and survival after second-look laparotomy in patients with advanced ovarian carcinoma.
 In ovarian cancer stages IIB-IV, pre-treatment variables and variables obtained intraoperatively at second-look laparotomy were investigated for their prognostic influence on the outcome of 109 patients and survival after second-look laparotomy in 131 patients.
 The subjects came from a randomized trial of sequential versus alternating combination chemotherapy.
 The overall median survival after second-look laparotomy was 62 months.
 Logistic regression analysis identified stage and hysterectomy plus bilateral salpingo-oophorectomy and omentectomy as significant prognostic covariates for second-look laparotomy outcome.
 Based on a Cox multivariate stepwise analysis, independent prognostic factors for survival after second-look laparotomy were secondary residual tumor size, pre-treatment histologic differentiation grade, and performance status.
 A high differentiation grade and a good performance status at the start of therapy thus still had a prolonging effect on survival after second-look laparotomy.
 The prognostic power of these pre-treatment variables was increased substantially by the addition of the secondary residual tumor size variable.
 The 3-year survival rate after second-look laparotomy for high- and low-risk patients was 15 and 87%, respectively.
 Second-look laparotomy thus provides prognostic information in patients with advanced ovarian carcinoma, but the benefit in terms of survival is still unclear.
