Background
Ovarian metastasis from colorectal cancer (CRC) is rare and lacks standard treatment. The benefit of metastatectomy remains to be elucidated. This study was conducted to assess the impact of metastatectomy on survival outcome and explore prognostic factors in ovarian metastatic CRC patients.
Results
Information of ovarian metastatic CRC patients between January 2008 and December 2017 were collected retrospectively from database of West China Hospital, Sichuan University. Totally, 68 female patients from a cohort of 2170 metastatic CRC cases were eligible. The median age at diagnosis was 46.5 years old. The median DSS was 25.0 months (95% confidence interval (CI): 21.0-29.0 months). Kaplan-Meier analysis and log-rank test showed that complete resection of ovarian metastases (median DSS: 33.0 months) could significantly prolong patients’ survival time, comparing with palliative and no resection (median DSS: 20.0 months and 22.0 months, respectively), regardless of systemic chemotherapy (P<0.05). Multivariate analysis demonstrated regional lymph nodes metastasis of primary tumor (hazard ratio (HR): 3.438, 95%CI: 1.094-10.810, P=0.035), primary tumor resection (HR: 6.436, 95%CI: 1.770-23.399, P=0.005), differentiation grade (HR: 0.272, 95%CI: 0.107-0.693, P=0.006), complete resection of ovarian metastases (versus palliative resection: HR: 17.091, 95%CI: 3.040-96.099, P=0.001; versus no resection: HR: 9.519, 95%CI: 1.581-57.320, P=0.014), and systemic chemotherapy (HR: 3.059, 95%CI: 1.089-8.595 P=0.034) were independent prognostic factors.
Conclusions
Complete resection of ovarian metastases could independently predict favorable survival in ovarian metastatic CRC, while palliative resection could not improve patients’ prognosis compared with no resection.