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.
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.
Authors: Carling Ursem; Margaret Zhou; Alan Paciorek; Chloe E Atreya; Andrew H Ko; Alan Venook; Li Zhang; Katherine Van Loon Journal: Oncologist Date: 2020-02-07