Role of surgery in the treatment of ovarian metastases from colorectal cancer

J Surg Oncol. 2009 Dec 1;100(7):570-4. doi: 10.1002/jso.21382.

Abstract

Background and objectives: The role of surgical resection in the treatment of metastatic ovarian tumors originating from colorectal cancer (CRC) remains uncertain. We sought to identify a subgroup of patients who would benefit from surgical resection.

Methods: We analyzed the clinicopathological and follow-up data on 34 patients who underwent surgical resection of metastatic ovarian tumors originating from CRC.

Results: Synchronous ovarian metastasis was detected in 27 patients (79.4%) and metachronous metastasis in 7 (20.6%). The histologic type of the primary CRC was adenocarcinoma in 26 patients (76.5%), mucinous carcinoma in 7 (20.6%), and signet ring cell carcinoma in 1 (2.9%). Complete cytoreduction was possible in 11 patients (32.4%). The 3-year overall survival (OS) rate was 25.1%. The median OS time was 19 months (range, 2-64 months) in all patients, and 36 months (range, 10-64 months) in patients who underwent complete cytoreduction. Cox's proportional hazards analysis showed that unilateral ovarian metastasis (relative risk [RR], 0.405; 95% confidence interval [CI], 0.171-0.959) and metastasis confined to the pelvic cavity (RR, 0.165; 95% CI, 0.031-0.878) were significantly associated with favorable prognosis.

Conclusions: Surgical resection may be beneficial in selected patients with ovarian metastasis arising from CRC, when metastasis is limited to the pelvis.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / secondary
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Signet Ring Cell / pathology
  • Carcinoma, Signet Ring Cell / secondary
  • Carcinoma, Signet Ring Cell / surgery
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / pathology*
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / secondary
  • Ovarian Neoplasms / surgery*
  • Ovariectomy
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / surgery
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate