Li Xiaofen, Huang Hai, Ran Longyao, Fang Chao, Yu Yongyang, Luo Manxi, Qiu Meng
Department of Abdominal Oncology, West China Hospital of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Department of Oncology, People's Hospital of Deyang City, Deyang, Sichuan, People's Republic of China.
Cancer Manag Res. 2020 Jun 12;12:4493-4501. doi: 10.2147/CMAR.S254876. eCollection 2020.
Ovarian metastasis from colorectal cancer (CRC) is rare and lacks standard treatment. The benefit of metastatectomy remains to be elucidated. This study was conducted to assess the impact of metastatectomy on survival outcome and explore prognostic factors in ovarian metastatic CRC patients.
Information of ovarian metastatic CRC patients between January 2008 and December 2017 were collected retrospectively from database of West China Hospital, Sichuan University. Kaplan-Meier method was used to estimate disease-specific survival (DSS) after diagnosis of ovarian metastasis, and multivariate Cox regression analysis was applied to identify prognostic factors.
Totally, 68 female patients from a cohort of 2170 cases were eligible. The median age at diagnosis was 46.5 years. The median DSS was 25.0 months (95% confidence interval (CI): 21.0-29.0 months). Kaplan-Meier analysis and Log rank test showed that complete resection of ovarian metastases (median DSS: 33.0 months) could significantly prolong patients' survival time, compared with palliative and no resection (median DSS: 20.0 months and 22.0 months, respectively), regardless of systemic chemotherapy (<0.05). Multivariate analysis demonstrated regional lymph nodes metastasis of primary tumor (hazard ratio (HR): 3.438, 95% CI: 1.094-10.810, =0.035), primary tumor resection (HR: 6.436, 95% CI: 1.770-23.399, =0.005), differentiation grade (HR: 0.272, 95% CI: 0.107-0.693, =0.006), complete resection of ovarian metastases (vs palliative resection: HR: 17.091, 95% CI: 3.040-96.099, =0.001; vs no resection: HR: 9.519, 95% CI: 1.581-57.320, =0.014), and systemic chemotherapy (HR: 3.059, 95% CI: 1.089-8.595 =0.034) were independent prognostic factors.
Complete resection of ovarian metastases could independently predict favorable survival in ovarian metastatic CRC, while palliative resection could not improve patients' prognosis compared with no resection.
结直肠癌（CRC）卵巢转移罕见且缺乏标准治疗方法。转移灶切除术的益处仍有待阐明。本研究旨在评估转移灶切除术对生存结局的影响，并探索卵巢转移CRC患者的预后因素。
回顾性收集四川大学华西医院数据库中2008年1月至2017年12月期间卵巢转移CRC患者的信息。采用Kaplan-Meier法估计卵巢转移诊断后的疾病特异性生存（DSS），并应用多因素Cox回归分析确定预后因素。
在2170例患者队列中，共有68例女性患者符合条件。诊断时的中位年龄为46.5岁。中位DSS为25.0个月（95%置信区间（CI）：21.0 - 29.0个月）。Kaplan-Meier分析和Log rank检验显示，与姑息性切除和未切除相比（中位DSS分别为20.0个月和22.0个月），完全切除卵巢转移灶（中位DSS：33.0个月）可显著延长患者的生存时间，无论是否进行全身化疗（<0.05）。多因素分析表明，原发肿瘤区域淋巴结转移（风险比（HR）：3.438，95%CI：1.094 - 10.810，P = 0.035）、原发肿瘤切除（HR：6.436，95%CI：1.770 - 23.399，P = 0.005）、分化程度（HR：0.272，95%CI：0.107 - 0.693，P = 0.006）、完全切除卵巢转移灶（与姑息性切除相比：HR：17.091，95%CI：3.040 - 96.099，P = 0.001；与未切除相比：HR：9.519，95%CI：1.581 - 57.320，P = 0.014）以及全身化疗（HR：3.059，95%CI：1.089 - 8.595，P = 0.034）是独立的预后因素。
完全切除卵巢转移灶可独立预测卵巢转移CRC患者的良好生存，而姑息性切除与未切除相比并不能改善患者的预后。
