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

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.