Colorectal cancer ovarian metastases. Issue 8 (3rd June 2021)

• Record Type: Journal Article
• Authors: Thornblade, Lucas W; Han, Ernest; Fong, Yuman
• Is Part Of: International journal of gynecological cancer. Volume 31:Issue 8(2021)
• Page Start: 1137
• Page End: 1144
• Publication Date: 2021-06-03
• Subjects: colorectal neoplasms -- ovarian neoplasms -- neoplasm metastasis; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2020-002328
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: Ovarian metastases occur in 3%–5% of patients with colorectal cancer. The role of oophorectomy in that setting continues to be debated. We aimed to assess the survival of women treated with metastasectomy for ovarian metastasis. Methods: Retrospective cohort study of patients in the California Cancer Registry (2000–2012) with stage IV colorectal cancer and ovarian metastases. Pathology other than adenocarcinoma was excluded. Adjusted Cox-proportional hazard analysis was applied to assess the risk of death. Results: A total of 756 patients with synchronous ovarian metastases and 516 patients with metachronous ovarian metastases form the basis of this analysis. Median follow-up for the synchronous cohort was 21 months (IQR: 8–36). Median overall survival was 23 months (IQR: 10–42). Estimated 5-year survival reached 17% and 10-year survival was 8%. There was a significant difference in unadjusted survival between patients with solitary ovarian metastasis (median overall survival: 51 months) compared with those who had both ovarian and extraovarian metastases (20 months) (log-rank test, P<0.0001). For patients with solitary ovarian metastases, the 5- and 10-year survival was 46% and 31%, respectively. Among patients with synchronous ovarian metastases, longer unadjusted survival was observed after oophorectomy (median overall survival: 24 months) compared with no oophorectomy (18 months, log-rank P=0.01). For patients with metachronous diagnoses of colorectal cancer ovarian metastasis, the median disease-free survival was 19 months. The median survival after resection of metachronous ovarian metastases was 25 months, with the survival directly related to the disease-free interval until metastasis. For patients with resected metachronous ovarian metastases, the 5- and 10-year post-metastasectomy survival was 14% and 5%, respectively. Conclusions: Patients with colorectal cancer ovarian metastasis have favorable long-term survival. Survival rates are higher if the tumor is isolated to the ovary or if metachronous to the primary cancer.