Outcome after ovarian/adnexal metastectomy in metastatic colorectal carcinoma

Ovarian metastases are reported to occur in 3-8% of women undergoing surgical resection of a primary colorectal adenocarcinoma. Information on clinical outcome after metastectomy for these patients is limited. Patients and Methods A computerized search of the medical record archive at the London Regional Cancer Centre (LRCC) identified 38 patients with metastatic colorectal cancer who underwent ovarian metastectomy between 1984-98.

Median age at diagnosis colorectal cancer was 54.5 years (range: 19-76). Nine women were <50 and 29 women were >50 years old at diagnosis of metastases. Ovarian metastases were diagnosed a median of 15 months (range: -2-65) after diagnosis of the primary malignancy. Complete resection was achieved in 19 patients. Nodal status of the primary tumor, presence of synchronous metastases, adjuvant therapy for colorectal cancer as well as interval to diagnosis of ovarian metastases had no significant effect on survival. Median survival for women aged <50 was 34.5 months vs. 17 months for those >50 (P = 0.22). Women with metastases confined to the pelvis survived a median of 31 months (range: 20-42) compared to 14 months for women with disease outside of the pelvis (P = 0.011). Median survival after complete metastectomy was 31 months (range: 24-45) and after palliative debulking was 14 months (range: 7-20) (P = 0.014).

Our results suggest that ovarian metastectomy may significantly improve overall survival in younger women able to undergo complete metastectomy for disease confined to the pelvis. Results also suggest that extent of disease and feasibility of complete resection may significantly impact on prognosis and must be carefully evaluated before surgery.