Complete resection of colorectal cancer with ovarian metastases combined with chemotherapy is associated with improved survival

2018 ◽  
Vol 89 (9) ◽  
pp. 1091-1096 ◽  
Author(s):  
Ibrahim S. Al‐Busaidi ◽  
Teresa Bailey ◽  
Bruce Dobbs ◽  
Tim W. Eglinton ◽  
Christopher J. Wakeman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Complete Resection ◽  
Ovarian Metastases

scholarly journals Impact of ovarian metastatectomy on survival outcome of colorectal cancer patients with ovarian metastasis: a retrospective study

2020 ◽  
Author(s):  
Xiaofen Li ◽  
Hai Huang ◽  
Longyao Ran ◽  
Chao Fang ◽  
Yongyang Yu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Primary Tumor ◽  
Systemic Chemotherapy ◽  
Ovarian Metastasis ◽  
Complete Resection ◽  
Survival Outcome ◽  
Palliative Resection ◽  
Ovarian Metastases ◽  
The Impact

Abstract 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.

Prognostic factors in patients undergoing complete resection of pulmonary metastases of colorectal cancer: a multi-institutional cumulative follow-up study

Surgery Today ◽  
2012 ◽  
Vol 43 (5) ◽  
pp. 494-499 ◽  
Author(s):  
Tomoichiro Hirosawa ◽  
◽  
Michio Itabashi ◽  
Takamasa Ohnuki ◽  
Naohito Yamaguchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastases ◽  
Complete Resection ◽  
Follow Up Study

scholarly journals Prognostic Impact of Macroscopic Complete Resection and Inflammatory Status for Colorectal Cancer With Peritoneal Dissemination

2018 ◽  
Vol 103 (7-8) ◽  
pp. 331-338
Author(s):  
Satoru Yamaguchi ◽  
Keisuke Ihara ◽  
Yosuke Shida ◽  
Haruka Yokoyama ◽  
Hideo Ogata ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peritoneal Metastasis ◽  
Peritoneal Dissemination ◽  
Prognostic Score ◽  
Case Series ◽  
Glasgow Prognostic Score ◽  
Carbohydrate Antigen ◽  
Complete Resection ◽  
Prognostic Impact ◽  
Inflammatory Status

Objective: To clarify the appropriate treatment policy for colorectal cancer with peritoneal metastasis, case series were analyzed retrospectively. Summary of background data: The frequency of colorectal cancer and peritoneal dissemination occurring simultaneously is 4% to 7%. The prevention of peritoneal metastasis and the development of a strategy for cure are considered important factors in improving the treatment outcome of colorectal cancer. Methods: A total of 60 patients with colorectal cancer with peritoneal dissemination were enrolled in this study. Tumor and host condition characteristics and treatment regimens affecting patient survival were tested by using Kaplan-Meier survival analysis. Results: Histologic type, carbohydrate antigen 19-9, macroscopic complete resection, and Glasgow Prognostic Score were found to be independent prognostic factors for overall survival. Conclusions: Peritoneal carcinomatosis can result in better patient prognoses in patients with well-differentiated carcinoma, less peritoneal spread, low levels of tumor markers, and a low Glasgow Prognostic Score. In these patients, curative resection of peritoneal metastases followed by intensive chemotherapy might be effective.

scholarly journals 171P Ovarian metastases resection of colorectal cancer: a clinical and pathological analysis of 15 patients

2015 ◽  
Vol 26 ◽  
pp. ix42
Author(s):  
J. Ikeda ◽  
K. Nanishi ◽  
T. Kumano ◽  
K. Imura ◽  
K. Shimomura ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ovarian Metastases ◽  
Pathological Analysis

Adjuvant Chemotherapy After Potentially Curative Resection of Metastases From Colorectal Cancer: A Pooled Analysis of Two Randomized Trials

2008 ◽  
Vol 26 (30) ◽  
pp. 4906-4911 ◽  
Author(s):  
Emmanuel Mitry ◽  
Anthony L.A. Fields ◽  
Harry Bleiberg ◽  
Roberto Labianca ◽  
Guillaume Portier ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Progression Free Survival ◽  
Pooled Analysis ◽  
Complete Resection ◽  
Hazard Ratio ◽  
Free Survival ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Purpose Adjuvant systemic chemotherapy administered after surgical resection of colorectal cancer metastases may reduce the risk of recurrence and improve survival, but its benefit has never been demonstrated. Two phase III trials (Fédération Francophone de Cancérologie Digestive [FFCD] Trial 9002 and the European Organisation for Research and Treatment of Cancer/National Cancer Institute of Canada Clinical Trials Group/Gruppo Italiano di Valutazione Interventi in Oncologia [ENG] trial) used a similar design and showed a trend favoring adjuvant chemotherapy, but both had to close prematurely because of slow accrual, thus lacking the statistical power to demonstrate the predefined difference in survival. We report here a pooled analysis based on individual data from these two trials. Patients and Methods After complete resection of colorectal liver or lung metastases, patients were randomly assigned to chemotherapy (CT arm; fluorouracil [FU] 400 mg/m2 administered intravenously [IV] once daily plus dl-leucovorin 200 mg/m2 [FFCD] × 5 days or FU 370 mg/m2 plus l-leucovorin 100 mg/m2 IV × 5 days [ENG] for six cycles at 28-day intervals) or to surgery alone (S arm). Results A total of 278 patients (CT, n = 138; S, n = 140) were included in the pooled analysis. Median progression-free survival was 27.9 months in the CT arm as compared with 18.8 months in the S arm (hazard ratio = 1.32; 95% CI, 1.00 to 1.76; P = .058). Median overall survival was 62.2 months in the CT arm compared with 47.3 months in the S arm (hazard ratio = 1.32; 95% CI, 0.95 to 1.82; P = .095). Adjuvant chemotherapy was independently associated with both progression-free survival and overall survival in multivariable analysis. Conclusion This pooled analysis shows a marginal statistical significance in favor of adjuvant chemotherapy with an FU bolus–based regimen after complete resection of colorectal cancer metastases.

The role of oophorectomy for colon cancer with ovarian metastasis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15113-e15113
Author(s):  
S. Lee ◽  
J. Lee ◽  
H. Ahn ◽  
J. Park ◽  
J. Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Poor Performance ◽  
Ovarian Metastasis ◽  
Control Group ◽  
Poor Performance Status ◽  
Ovarian Metastases ◽  
Colorectal Cancer Patients

e15113 Background: A recent study demonstrated that colorectal cancer with ovarian metastases were less responsive to chemotherapy compared to extraovarian metastases. Hence, the ovary may actually represent a “sanctuary” for metastatic cells from CRC. The aim of the study was to investigate the impact of oophorectomy on survival of colorectal cancer patients with ovarian metastasis. Methods: Between 1996 and 2008, 83 colorectal cancer patients underwent oophorectomy. For the historical control, 47 colorectal cancer patients without oophorectomy were included in the analysis. Survival and its associated factors were analyzed using Kaplan-Meier method, log-rank test and Cox-regression analysis. Results: The median age was younger (48 years) in the oophorectomy group when compared to the historical control (54 years) (P =.012). The proportion of synchronous metastasis was higher in the oophorectomy than the control group (57% vs 30%, respectively; P=.003). After a median follow-up duration of 60.8 months (range, 7.4 - 169.7 months), the median OS was significantly longer in the oophorectomy group (28.1 vs 21.2 months, oophorectomy vs non-oophoreectomy; P=.038). For ovary-specific survival (date of ovarian metastasis diagnosis to death), colorectal cancer patients with oophorectomy showed significantly favorable survival than the control group (20.8 vs 10.9 months, respectively; P<.001). At univariate analyses, no oophorectomy (P=.038), bilaterality of ovarian metastasis (P=0.032), the presence of extraovarian metastasis (P<0.001), elevated CEA (p<0.001), poor performance status (p=0.001), no palliative chemotherapy(p=0.001), no primary disease resection(p=0.005) were identified as significantly poor prognostic factors for overall survival. The no oophorectomy, no chemotherapy, extraovarian metastasis, elevated CEA, poor performance status retained statistical significance at multivariate level. (p=0.003, p=0.004, p=0.005, p=0.015, p=0.029, respectively). Conclusions: Based on this retrospective analysis, the oophorectomy significantly prolonged survival in colorectal cancer patients with ovarian metastases. A potential role of oophorectomy in the management of colorectal cancer should be prospectively studied. No significant financial relationships to disclose.

Retrospective analysis of the effects of systemic chemotherapy to the ovarian metastases from colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 731-731 ◽  
Author(s):  
Katsutoshi Sekine ◽  
Tetsuya Hamaguchi ◽  
Hirokazu Shoji ◽  
Shoko Nakamura ◽  
Takahiro Miyamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Cytoreductive Surgery ◽  
Systemic Chemotherapy ◽  
Palliative Chemotherapy ◽  
Objective Response ◽  
First Line ◽  
Ovarian Metastases ◽  
Third Line ◽  
Metastatic Sites

731 Background: Ovarian metastases from colorectal cancers are relatively rare. Since most ovarian metastases are also associated with other metastatic sites, the prognosis is reported to be poor. It is not fully understood whether the response to systemic chemotherapy of ovarian metastases differs from that to other metastatic sites. Methods: We retrospectively reviewed the clinical data of patients with ovarian metastases from colorectal cancer treated at our hospital between January 2006 and December 2015. Results: Among the 635 female patients with relapsed or metastatic colorectal cancer, 57 (9.0%) had ovarian metastases before the first-line treatment; 37 patients received palliative chemotherapy, and 20 patients were initially treated by surgical resection. In addition, 38 cases of ovarian metastases developed after the initiation of first-line chemotherapy. Overall, 95 patients (15.0%) with ovarian metastases were treated during this period. The objective response rate for systemic chemotherapy of ovarian metastases was lower than that for other metastatic sites (22.9 % vs 60.9 % for first-line, 3.4 % vs 13.6 % for second-line, 11.1 % vs 26.6 % for third-line, and 0% vs 18.2 % for fourth-line, respectively). After the initiation of chemotherapy, surgical resection of ovarian metastases was positively associated with a longer overall survival (26.8 months for cytoreductive surgery and 17.0 months for only systemic chemotherapy, p < 0.001), especially when the other metastatic sites had not progressed after chemotherapy. Conclusions: Ovarian metastases are less responsive to systemic chemotherapy compared to the extra-ovarian metastases. Our data also suggest that multi-disciplinary treatment strategy including systemic chemotherapy and cytoreductive surgery might improve the prognosis of ovarian metastases.

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