Ovarian metastases resection of colorectal cancer: a clinical and pathological analysis of 15 patients

Aim/Background

To explore the manifestation of patients treated with ovarian metastasis resection of colorectal cancer.

Methods

A total of 15 patients diagnosed with ovarian metastasis of colorectal cancer who underwent oophorectomy at a single institution between 2007 and 2015 were retrospectively evaluated.

Results

9(60%) patients had certain symptoms like abdominal pain or distention on the detection of ovarian tumor, while 6(40%) had no symptoms. Metachronous ovarian metastasis occurred in 7(46.7%) and synchronous metatsis in 8(53.3%) patients. The median period between primary tumor resection and oophorectomy in the patients with metachronous ovarian metastasis was 14 months (8-36 months). Combined metastases occurred in 10 patients (66.7%), including peritoneal metastasis in 7 of the patients and liver metastasis in 5. Bilateral ovarian metastasis was found in 7 patients (46.7%). The median ovarian metastasis tumor size was 10 cm. The regions of primary tumor were on the sigmoid colon in 6 patients, the rectum in 5, the ascending colon in 2 and the transverse colon in 2. As the pathological features of primary tumor, a well-differentiated type and a moderately differentiated type were seen in 13 (86.7%), subserosa or deeper invasion were seen in all patients (100%) and lymph-node metastasis was seen in 10 (66.7%).The median follow-up period was 18 months (3-80 months). 6 patients who underwent oophorectomy have currently been alive, including 3 with no carcinoma progression. 2 patients have been alive for more than 3 years since undergoing oophorectomy.

Conclusions

In cases of ovarian metastasis of colorectal cancer, oophorectomy should be recommended due to the possibility of longer survival period than other treatments. Even if an extra-ovarian metastasis coexists, oophorectomy followed by chemotherapy is more effective than chemotherapy alone since ovarian metastasis shows certain symptoms derived from the enlarged tumor and resistance against chemotherapy.

Clinical trial identification

Disclosure

All authors have declared no conflicts of interest.