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Colorectal cancer ovarian metastases
  1. Lucas W Thornblade1,
  2. Ernest Han2 and
  3. Yuman Fong1
  1. 1 Surgical Oncology, City of Hope National Medical Center, Duarte, California, USA
  2. 2 Gynecologic Oncology, City of Hope National Medical Center, Duarte, California, USA
  1. Correspondence to Dr Lucas W Thornblade, City of Hope National Medical Center, Duarte, CA 91010, USA; lucas.thornblade{at}gmail.com

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.

  • colorectal neoplasms
  • ovarian neoplasms
  • neoplasm metastasis

Data availability statement

Data may be obtained from a third party and are not publicly available. The data in this study are obtained under license from the California Cancer Registry. Statistical analysis is available upon request.

Statistics from Altmetric.com

Data availability statement

Data may be obtained from a third party and are not publicly available. The data in this study are obtained under license from the California Cancer Registry. Statistical analysis is available upon request.

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Footnotes

  • Twitter @lthornblade

  • Contributors LWT, EH, and YF each contributed to the design, implementation, and writing of this research manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests YF paid scientific advisor to Medtronic, Johnson and Johnson, and Olympus, unrelated to the content of this paper.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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