[The value of oophorectomy in colorectal cancer with ovarian metastasis and multiple distant organ metastases].

Objective: Exploring the therapeutic value of ovarianectomy in patients with colorectal cancer accompanied by ovarian metastasis and simultaneous multiple organ distant metastasis. Methods: A retrospective analysis was conducted on the clinical pathological data of 125 patients with colorectal cancer and ovarian metastasis accompanied by multiple organ distant metastasis, who were treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2014 to December 2023. Based on whether ovarianectomy was performed, patients were divided into a surgical group (95 cases, 76.0%) and a non-surgical group (30 cases, 24.0%). The effectiveness of systemic treatment and overall survival (OS) were compared between the two groups. Results: Among the 95 patients in the surgical group, 8 patients (8.4%) experienced minor postoperative complications, with no instances of systemic treatment being affected by postoperative complications. Within the surgical group, 11 patients (11.6%) underwent preoperative neoadjuvant therapy. Postoperative pathological reports from these patients revealed that ovarian metastases exhibited the poorest treatment response compared to tumor foci in other sites, all demonstrating only mild therapeutic effects. All 95 patients in the surgical group received postoperative systemic treatment (chemotherapy±targeted therapy), and the efficacy was assessed. Among them, 16 patients (16.8%) had partial remission (PR), 57 patients (60.0%) had stable disease (SD), 3 patients (3.2%) had disease progression (PD), and 19 patients (20.0%) could not be evaluated. In the non-surgical group of 30 patients, 7 (23.3%) had SD and 23 (76.7%) had PD. The difference in efficacy between the two groups was statistically significant (P＜0.001). The median OS for all patients was 28 months (95% CI: 21.5-34.5), with 1-, 3-, and 5-year survival rates of 84.5%, 40.7%, and 23.9%, respectively. The median OS for patients in the surgical group was 35 months (95% CI: 23.9-46.1), with 1-, 3-, and 5-year survival rates of 87.1%, 45.0%, and 26.4%, respectively. The median OS for patients in the non-surgical group was 23 months (95% CI: 16.6-29.4), with 1-, 3-, and 5-year survival rates of 76.2%, 27.8%, and 13.9%, respectively. The prognosis of patients in the surgical group was significantly better than that in the non-surgical group (P=0.034). Conclusion: Performing ovarianectomy in patients with colorectal cancer and ovarian metastases accompanied by multiple organ distant metastases can prolong survival, improve the efficacy of systemic treatment, and enhance quality of life, resulting in significant overall clinical benefits.