Yoshihara Terukazu, Noura Shingo, Tanida Tsukasa, Ogino Takayuki, Noguchi Kozo, Nagase Hirotsugu, Hirota Masashi, Tomimaru Yoshito, Imamura Hiroshi, Dono Keizo
Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.
J Anus Rectum Colon. 2021 Jan 28;5(1):40-45. doi: 10.23922/jarc.2020-047. eCollection 2021.
In the 9th edition of the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma (JCCRC), ovarian metastasis is classified as distant metastasis. We assessed the significance of resection of ovarian metastases and the validity of this 9th edition of JCCRC for ovarian metastases from colorectal cancer (CRC).
We retrospectively analyzed the clinicopathological factors and overall survival of 17 patients with ovarian metastases from CRC who underwent resection and 110 female CRC patients with Stage IV (M1a) disease.
The patients with only ovarian metastases who underwent resection had a longer median survival time than patients with both ovarian and peritoneal metastases who underwent resection (45.4 months vs. 9.3 months, = 0.029). The 5-year overall survival of the patients with only ovarian metastases who underwent R0 resection was as long as that of the female Stage IV (M1a) CRC patients after R0 resection (50% vs. 48%, = 0.334).
We found that, after resection, patients with only ovarian metastases had significantly better prognoses than patients with ovarian and peritoneal metastases. R0 resection of ovarian metastasis indicated as good prognosis as R0 resection of metastasis to one distant organ without ovaries. So the 9th edition of JCCRC, which classifies ovarian metastasis from CRC as distant metastasis, is appropriate.
在日本结直肠癌、阑尾癌和肛管癌分类(JCCRC)第9版中,卵巢转移被归类为远处转移。我们评估了切除卵巢转移灶的意义以及JCCRC第9版对结直肠癌(CRC)卵巢转移的有效性。
我们回顾性分析了17例接受手术切除的CRC卵巢转移患者以及110例IV期(M1a)女性CRC患者的临床病理因素和总生存期。
仅接受卵巢转移灶切除的患者中位生存时间长于同时接受卵巢和腹膜转移灶切除的患者(45.4个月对9.3个月,P = 0.029)。接受R0切除的仅卵巢转移患者的5年总生存率与接受R0切除的IV期(M1a)女性CRC患者的5年总生存率一样长(50%对48%,P = 0.334)。
我们发现,切除术后,仅卵巢转移患者的预后明显好于卵巢和腹膜转移患者。卵巢转移灶的R0切除显示出与无卵巢的一个远处器官转移灶的R0切除一样好的预后。因此,JCCRC第9版将CRC的卵巢转移归类为远处转移是合适的。