Faculty Collaboration Database

Synchronous ovarian metastases at the time of laparotomy for colon cancer. Gynecol Oncol 2004 Mar;92(3):851-5

Date

02/27/2004

Pubmed ID

14984952

DOI

10.1016/j.ygyno.2003.12.017

Scopus ID

2-s2.0-1342279508 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

OBJECTIVE: The aim of the study was to identify clinical features, define prognostic factors and optimize treatment in patients with colorectal cancer with synchronous ovarian metastases at the time of initial diagnosis.

METHODS: A retrospective analysis of patients treated by the gynecologic oncology service at Barnes Jewish Hospital between 1990 and 2001 was performed. Twenty-eight patients with colorectal carcinomas with synchronous ovarian metastases at the time of diagnosis were identified. Clinical and pathological characteristics were evaluated, and survival was analyzed by the method of Kaplan and Meier.

RESULTS: Abdominal pain was the most common symptom at presentation. Only 14% of the patients presented with gastrointestinal bleeding. Fifty-four percent of patients who underwent barium enema had intrinsic colonic lesions, while 40% of patients who had endoscopies performed had their colonic tumors identified. Preoperatively colon cancer was considered in the differential diagnosis of 71% of the patients. At exploration, the ovarian metastases were significantly larger than the primary colon tumors. Overall, 68% of patients had intraperitoneal nodal metastasis and 86% had transmural extension of their tumors. The only pathological variable associated with survival was tumor grade. The median disease-free survival was 10.3 months while the median overall survival was 18.4 months.

CONCLUSION: Most patients with colon cancer with synchronous ovarian metastases present with vague symptoms. At exploration, locally advanced tumors and other distant metastases such as in the liver are common. Surgical management should include extirpation of the primary tumor and any bulky ovarian metastases. Cytoreduction may be considered in highly selected patients.

Author List

Wright JD, Powell MA, Mutch DG, Rader JS, Gibb RK, Huettner PC, Herzog TJ

Author

Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Colonic Neoplasms
Female
Humans
Hysterectomy
Laparotomy
Middle Aged
Ovarian Neoplasms
Prognosis
Retrospective Studies