Department of Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Internal Medicine, Saitama Municipal Hospital, Saitama-city, Japan.
Oncology. 2018;95(4):220-228. doi: 10.1159/000489665. Epub 2018 Jul 20.
Ovarian metastases from colorectal cancers are relatively rare. Since most ovarian metastases are associated with metastases at other sites, the prognosis is usually poor. Few reports exist that describe the clinical course of colorectal cancer patients with ovarian metastasis, including the chemotherapy response.
We retrospectively reviewed the clinical data of patients with ovarian metastases from colorectal cancer treated at the National Cancer Center Hospital, Tokyo, between January 2006 and December 2015.
Thirty-seven patients with ovarian metastases received palliative chemotherapy as first-line treatment. The objective response rate for systemic chemotherapy of ovarian metastases was significantly lower than that for other metastatic sites (23.5 vs. 63.6% for first-line, respectively, p = 0.0047). Following chemotherapy, the additional surgical resection of ovarian metastases was positively associated with longer overall survival (OS) compared to no surgical resection (43.1 vs. 17.0 months, respectively, p = 0.0016). Furthermore, cytoreductive surgery was also positively associated with longer OS, especially when other metastatic sites were well controlled.
Ovarian metastases are less responsive to systemic chemotherapy compared to extra-ovarian metastases in patients with relapsed or metastatic colorectal cancer. Multidisciplinary treatment strategy, including systemic chemotherapy and cytoreductive surgery, may contribute to the prolongation of OS.
结直肠癌卵巢转移相对少见。由于大多数卵巢转移与其他部位转移相关,因此预后通常较差。鲜有报道描述结直肠癌伴卵巢转移患者的临床经过,包括化疗反应。
我们回顾性分析了 2006 年 1 月至 2015 年 12 月期间在日本国立癌症中心医院接受治疗的结直肠癌卵巢转移患者的临床资料。
37 例卵巢转移患者接受姑息性化疗作为一线治疗。卵巢转移的全身化疗客观缓解率明显低于其他转移部位(分别为一线治疗的 23.5%和 63.6%,p=0.0047)。与未行手术切除相比,化疗后卵巢转移的进一步手术切除与总生存期(OS)延长显著相关(分别为 43.1 个月和 17.0 个月,p=0.0016)。此外,肿瘤细胞减灭术与 OS 延长也显著相关,特别是在其他转移部位得到良好控制的情况下。
与结直肠癌复发或转移患者的卵巢外转移相比,卵巢转移对全身化疗的反应性较差。包括全身化疗和肿瘤细胞减灭术在内的多学科治疗策略可能有助于延长 OS。