Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, People's Republic of China.
Department of Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
World J Surg Oncol. 2021 Jul 20;19(1):220. doi: 10.1186/s12957-021-02305-3.
The aim of this study was to analyze prognostic factors for ovarian metastases (OM) in colorectal cancer (CRC) using data from a Chinese center. In addition, the study aimed at developing a new clinical scoring system for prognosis of OM of CRC patients after surgery.
Data of CRC patients with OM were collected from a single Chinese institution (n = 67). Kaplan-Meier analysis was used to evaluate cumulative survival of patients. Factors associated with prognosis of overall survival (OS) were explored using Cox's proportional hazard regression models. A scoring system to determine effectiveness of prognosis was developed.
Median OS values for patients with or without surgery were 22 and 7 months, respectively. Size of OM, number of OM, peritoneal metastasis (PM), Peritoneal cancer index (PCI), and completeness of cytoreduction (CC) were associated with OS of patients through univariate analysis. Multivariate analysis using a Cox regression model showed that only CC was an independent predictor for OS. Three variables (the size of OM >15cm, PCI ≥ 10, and carcinoembryonic antigen (CEA) >30 ng/mL) assigned one point each were used to develop a risk score. The resulting score was used for prognosis of OS.
Surgical treatment of metastatic sites is effective and safe for CRC patients with OM. CC-0 is recommended for improved prognosis. The scoring system developed in this study is effective for prediction of OS of patients after surgery.
本研究旨在分析中国中心数据中结直肠癌（CRC）卵巢转移（OM）的预后因素。此外，本研究旨在为 CRC 患者手术后 OM 的预后建立新的临床评分系统。
本研究从单一中国机构（n=67）收集了 CRC 伴 OM 患者的数据。采用 Kaplan-Meier 分析评估患者的累积生存率。使用 Cox 比例风险回归模型探讨与总生存（OS）预后相关的因素。建立了一个评分系统来确定预后的有效性。
有手术和无手术患者的中位 OS 值分别为 22 个月和 7 个月。OM 大小、OM 数量、腹膜转移（PM）、腹膜癌症指数（PCI）和细胞减灭术的完全程度（CC）通过单因素分析与患者的 OS 相关。Cox 回归模型的多因素分析表明，只有 CC 是 OS 的独立预测因素。使用 Cox 回归模型的多因素分析表明，只有 CC 是 OS 的独立预测因素。三个变量（OM 大小>15cm、PCI≥10 和癌胚抗原（CEA）>30ng/mL）各赋值 1 分，用于开发风险评分。由此产生的评分用于预测 OS。
对于 CRC 伴 OM 患者，手术治疗转移部位是有效和安全的。建议达到 CC-0 以改善预后。本研究建立的评分系统对预测患者手术后的 OS 是有效的。
