Department of Surgery, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands.
Br J Surg. 2011 Feb;98(2):287-92. doi: 10.1002/bjs.7303.
The incidence of ovarian metastases at the time of peritoneal carcinomatosis, and the influence of such metastases on survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), are unknown.
This retrospective analysis included 194 women subjected to CRS and HIPEC since 2001. The incidence of ovarian metastases, disease-free survival and disease-specific survival were analysed.
The histological diagnosis was colorectal cancer carcinomatosis in 108 patients, peritoneal mucinous carcinomatosis (PMCA) in 23 and disseminated peritoneal adenomucinosis (DPAM) in 63. Ninety-nine patients underwent oophorectomy during the HIPEC procedure. Ovarian metastases were confirmed in at least 52 per cent of the patients. There was a significant difference in disease-free survival between women with or without ovarian metastases in both PMCA and DPAM groups (P = 0·044 and P = 0·010 respectively). No significant differences in survival were found in the group with colorectal cancer carcinomatosis.
When peritoneal carcinomatosis of colorectal or appendiceal origin is confirmed, at least 52 per cent of ovaries will have synchronous metastases. Disease-free survival after a HIPEC procedure for PMCA or DPAM is significantly lower in women with ovarian metastases. Oophorectomy during CRS for peritoneal carcinomatosis should be strongly considered.
在腹膜癌转移时发生卵巢转移的发生率，以及这种转移对细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）后生存的影响尚不清楚。
本回顾性分析纳入了自 2001 年以来接受 CRS 和 HIPEC 的 194 名女性。分析了卵巢转移的发生率、无病生存率和疾病特异性生存率。
108 例患者的组织学诊断为结直肠癌腹膜转移，23 例为腹膜黏液性癌（PMCA），63 例为播散性腹膜黏液腺癌（DPAM）。99 例患者在 HIPEC 手术期间行卵巢切除术。至少有 52%的患者被证实存在卵巢转移。在 PMCA 和 DPAM 组中，有或无卵巢转移的女性患者的无病生存率有显著差异（P=0.044 和 P=0.010）。在结直肠癌腹膜转移组中未发现生存率的显著差异。
当确认结直肠或阑尾来源的腹膜癌转移时，至少 52%的卵巢将存在同步转移。对于 PMCA 或 DPAM 接受 HIPEC 手术后，有卵巢转移的女性患者无病生存率显著降低。对于腹膜癌转移的 CRS 期间应强烈考虑行卵巢切除术。
