Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
School of Life Science, Tsinghua University, Beijing, 100142, China; PekingTsinghua Center for Life Science, Peking University International Cancer Center, Beijing, 100142, China.
Eur J Surg Oncol. 2023 Sep;49(9):106961. doi: 10.1016/j.ejso.2023.06.013. Epub 2023 Jun 16.
Patients with ovarian metastasis of colorectal cancer (CROM) usually have poor prognosis. Metastasectomy is controversial in patients with CROM. This study aims to evaluate the prognostic value of ovarian metastasectomy and other factors in CROM patients.
We searched literature up to November 1, 2021 in MEDLINE (PubMed), Embase, Cochrane Library, and Clinicaltrials.gov. Retrospective studies were assessed if survival outcome of CROM patients was reported. Results were pooled in a random-effects model and reported as hazard ratios (HRs) with 95% confidence intervals (CI). Sensitivity was analyzed.
Among 2497 studies screened, 15 studies with 997 patients, published between 2000 and 2021, were included. Longer overall survival (OS) was correlated with ovarian metastasectomy (pooled HR = 0.44, 95% CI: 0.34-0.58, P < 0.05) and R0 resection (pooled HR = 0.26, 95% CI: 0.16-0.41, P < 0.05). Longer disease-specific survival (DSS) was associated with systematic chemotherapy (pooled HR = 0.26, 95% CI: 0.15-0.45, P < 0.0001). Shorter OS was associated with extraovarian metastases (pooled HR = 3.00, 95% CI 1.68-5.36, P < 0.05) and bilateral OM (pooled HR = 1.66, 95% CI: 1.09-2.51, P < 0.05). No significant difference in OS was observed among patients with systematic chemotherapy (pooled HR = 0.68, 95% CI: 0.35-1.31, P > 0.05).
Metastasectomy achieving R0 resection can significantly prolong OS and DSS of CROM patients as a reasonable treatment modality. Primary tumor resection and systematic chemotherapy can improve patients' outcomes.
CRD42022299185 (http://www.crd.york.ac.uk/PROSPERO).
患有结直肠癌卵巢转移（CROM）的患者通常预后较差。卵巢转移切除术在 CROM 患者中存在争议。本研究旨在评估卵巢转移切除术及其他因素在 CROM 患者中的预后价值。
我们检索了截至 2021 年 11 月 1 日在 MEDLINE（PubMed）、Embase、Cochrane 图书馆和 Clinicaltrials.gov 上的文献。如果报道了 CROM 患者的生存结局，则评估回顾性研究。采用随机效应模型汇总结果，并以 95%置信区间（CI）表示风险比（HR）。分析了敏感性。
在筛选出的 2497 篇研究中，纳入了 15 项研究的 997 例患者，这些研究发表于 2000 年至 2021 年之间。总生存期（OS）较长与卵巢转移切除术（汇总 HR=0.44，95%CI：0.34-0.58，P<0.05）和 RO 切除术（汇总 HR=0.26，95%CI：0.16-0.41，P<0.05）相关。疾病特异性生存期（DSS）较长与系统化疗（汇总 HR=0.26，95%CI：0.15-0.45，P<0.0001）相关。OS 较短与卵巢外转移（汇总 HR=3.00，95%CI 1.68-5.36，P<0.05）和双侧 OM（汇总 HR=1.66，95%CI：1.09-2.51，P<0.05）相关。接受系统化疗的患者 OS 无显著差异（汇总 HR=0.68，95%CI：0.35-1.31，P>0.05）。
达到 RO 切除的转移切除术可显著延长 CROM 患者的 OS 和 DSS，是一种合理的治疗方式。原发肿瘤切除术和系统化疗可改善患者的结局。
CRD42022299185（http://www.crd.york.ac.uk/PROSPERO）。
