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积极的手术干预可能改善结直肠癌卵巢转移患者的预后。

Aggressive surgical intervention may improve prognosis in patients with ovarian metastasis from colorectal cancer.

机构信息

Department of Gastroenterological Surgery, Osaka Rosai Hospital, Nagasone 1179-3, Kita Ward, Sakai, Osaka, 591-8025, Japan.

出版信息

Langenbecks Arch Surg. 2023 Aug 16;408(1):313. doi: 10.1007/s00423-023-03060-7.

Abstract

PURPOSE

The current study aimed to investigate the prognostic clinicopathological factors of synchronous and metachronous ovarian metastasis (OM) from colorectal cancer (CRC) in patients with and without oophorectomy.

METHODS

Female patients with OM from CRC who underwent primary tumor resection at our institution from January 2013 to December 2020 were evaluated.

RESULTS

Of 661 female patients, 22 (3.3%) were diagnosed with OM. Among 22 patients with OM, 12 underwent OM resection. Twenty (91%) patients had extra OM upon diagnosis. Thirteen (59%) patients in the non-surgery group had peritoneal dissemination at surgery or on computed tomography scan or positron emission tomography-computed tomography. Two patients in the OM surgery group had emergency surgery because of abdominal pain. Four patients had postoperative complications, and the median duration of hospital admission was 16.5 days. The median survival time from OM diagnosis to mortality was 20.9 months. Then, the association between the clinicopathological factors and overall survival (OS) was investigated. Tumor location and surgery were found to be related to OS (p = 0.03, 0.006, respectively) in the univariate analysis. However, only surgery was associated with OS (p = 0.02) in the multivariate analysis.

CONCLUSION

Surgery is an important prognostic clinicopathological factor of OM from CRC. OM tumors should be resected because OM surgery is less likely to cause complications and symptoms.

摘要

目的

本研究旨在探讨行卵巢切除术与未行卵巢切除术的结直肠癌(CRC)患者同步性和异时性卵巢转移(OM)的预后临床病理因素。

方法

评估了 2013 年 1 月至 2020 年 12 月在我院行原发肿瘤切除术的 CRC 伴 OM 的女性患者。

结果

在 661 例女性患者中,22 例(3.3%)诊断为 OM。在 22 例 OM 患者中,12 例行 OM 切除术。20 例(91%)患者在诊断时存在额外的 OM。非手术组 13 例(59%)患者在手术时或 CT 扫描或正电子发射断层扫描-CT 上存在腹膜播散。2 例 OM 手术组患者因腹痛而行急诊手术。4 例患者发生术后并发症,中位住院时间为 16.5 天。从 OM 诊断到死亡的中位生存时间为 20.9 个月。然后,研究了临床病理因素与总生存期(OS)的关系。单因素分析发现肿瘤位置和手术与 OS 相关(p=0.03,0.006)。但多因素分析仅发现手术与 OS 相关(p=0.02)。

结论

手术是 CRC 伴 OM 的重要预后临床病理因素。OM 肿瘤应行切除术,因为 OM 手术不太可能引起并发症和症状。

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