Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Oncology. 2024;102(2):114-121. doi: 10.1159/000533599. Epub 2023 Sep 12.
Ovarian metastasis of colorectal cancer is known to have a poor prognosis. This study aimed to elucidate the characteristics of patients who underwent oophorectomy for ovarian metastasis from colorectal cancer.
This retrospective study included 16 patients who underwent oophorectomy for colorectal cancer metastasis to the ovary from January 2004 to December 2017. Improvement in patient's symptoms and pre- and postoperative changes in various nutritional and inflammatory indicators were assessed. Survival analysis and identification of prognostic factors were conducted with a median follow-up of 40.7 (5-109) months.
Of 16 patients, 12 had (75%) synchronous and 4 (25%) had metachronous metastasis. Fourteen patients were symptomatic but symptoms resolved postoperatively. Thirteen patients (81.3%) had ascites and 5 (31.3%) had pleural effusion on preoperative computed tomography that disappeared after surgery in all cases. The median value of prognostic nutritional factor was significantly increased postoperatively (36.0 [preoperatively] vs. 47.5, p < 0.0001). The median (interquartile range) values for lymphocyte-C-reactive protein ratio were 715.2 (110-2,607) preoperatively and 6,095.2 (1,612.3-14,431.8) postoperatively (p = 0.0214). The median survival of the entire cohort was 60.4 months. The 3-year survival rates for R0 + R1 and R2 cases were 83% and 24% (p = 0.018), respectively. Univariate analysis showed that R2 resection and low postoperative lymphocyte-C-reactive protein ratio were associated with poor prognosis.
Oophorectomy for ovarian metastasis from colorectal cancers was safely performed. It improved the patients' symptoms and nutritional status and may result in improved prognosis.
已知结直肠癌卵巢转移的预后较差。本研究旨在阐明因结直肠癌转移至卵巢而接受卵巢切除术的患者的特征。
本回顾性研究纳入了 2004 年 1 月至 2017 年 12 月期间因结直肠癌转移至卵巢而接受卵巢切除术的 16 名患者。评估了患者症状的改善以及各种营养和炎症指标的术前和术后变化。中位随访 40.7（5-109）个月后，进行生存分析和预后因素的识别。
16 名患者中，12 名（75%）为同步转移，4 名（25%）为异时转移。14 名患者有症状，但术后症状缓解。术前 CT 显示 13 名患者（81.3%）有腹水，5 名患者（31.3%）有胸腔积液，所有患者术后均消失。术后预测营养因子的中位数明显升高（36.0[术前] vs. 47.5，p < 0.0001）。术前淋巴细胞- C 反应蛋白比值的中位数（四分位距）为 715.2（110-2607），术后为 6095.2（1612.3-14431.8）（p = 0.0214）。整个队列的中位生存时间为 60.4 个月。R0 + R1 病例和 R2 病例的 3 年生存率分别为 83%和 24%（p = 0.018）。单因素分析显示，R2 切除和术后淋巴细胞- C 反应蛋白比值低与预后不良相关。
结直肠癌卵巢转移的卵巢切除术是安全的。它改善了患者的症状和营养状况，并可能改善预后。
