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Complete resection of colorectal cancer with ovarian metastases combined with chemotherapy is associated with improved survival
Author(s) -
AlBusaidi Ibrahim S.,
Bailey Teresa,
Dobbs Bruce,
Eglinton Tim W.,
Wakeman Christopher J.,
Frizelle Frank A.
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14930
Subject(s) - medicine , colorectal cancer , chemotherapy , oncology , ovarian cancer , resection , overall survival , general surgery , surgery , cancer
Background Ovarian metastases (OM) from colorectal cancer (CRC) are uncommon, and data about optimal management are lacking. The aim of this study was to examine the management and outcomes of patients with OM from CRC. Methods A retrospective review of records of patients with a histopathological diagnosis of OM from CRC who were treated at Christchurch Hospital between 1 January 2000 and 31 December 2016. Data related to presentation, clinicopathological characteristics, treatment and outcomes were recorded. The primary outcomes were overall survival and disease‐free survival. Results Thirty‐one patients were identified (median age 55 years, range 28–77), with a median follow‐up of 23 months (range 3–84 months). Abdominal pain was the most common presenting symptom (22 patients). Synchronous OM occurred in 22 patients, 14 patients had bilateral ovarian involvement. Twenty‐one patients received adjuvant chemotherapy. R0 resection was achieved in 14 patients. For all patients the 5‐year disease‐free and overall survival were 11% and 12%, respectively, while 5‐year overall survival for R0 resections was 30%. Improved median survival was associated with negative colon resection margins (26.7 months versus 7.8 months, P = 0.03), R0 resection (30.5 months versus 23.5 months, P = 0.04), and use of adjuvant chemotherapy (28.8 months versus 8.2 months, P < 0.0001); however, on multivariate analysis adjuvant chemotherapy was the only independent factor associated with improved prognosis ( P = 0.01). Conclusions OM from CRC are uncommon and carry a poor prognosis. Improved survival was associated with complete surgical resection of the primary tumour and metastatic disease in combination with systemic chemotherapy.