The majority of patients demonstrate a complete clinical response to initial debulking and chemotherapy with physical examination, CT scan and CA-125 levels all normal. But of these, about half still have disease as defined by negative biopsy specimens on a second look laparotomy.
The discovery of disease itself has little effect on survival so present day policy is to recommend second look laparotomy only if further treatment is to be considered. The guidelines for managing persistent disease are less established. Treatment options include:
Whole abdomen radiotherapy seems to be ineffective.
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