Ovarian metastases resection from extragenital primary sites:outcome and prognostic factor analysis of 147 patients Full Text
Li W-H et al. – Ovarian metastases are more commonly seen to originate from primary gastrointestinal tract. The prognosis of ovarian metastasis is dismal and the benefit of ovarian metastatectomy is limited. Those with combined metastasis outside ovaries, locally invasion and massive intraoperative ascites were independent factors for predicting unfavorable overall survival. The identification of the primary tumor is required to plan for adequate treatment for this group of patients.Methods
- Patients with ovarian metastases from extragenital primary cancer confirmed by laparotomy surgery and ovarian metastases resection were retrospectively collected in a single institution during an 8-year period.
- A total of 147 cases were identified and primary tumor sites were colorectal region (49.0%), gastric (40.8%), breast (8.2%), biliary duct (1.4%) and liver (0.7%).
- Patients' outcome with different primary tumor sites and predictive factors for overall survival were also investigated by univariate and multivariate analysis.
- Metachronous ovarian metastasis occurred in 92 (62.6%) and synchronous in 55 (37.4%) patients.
- Combined metastases occurred in 40 (27.2%).
- Bilateral metastasis was found in 97 (66%) patients.
- The median ovarian metastasis tumor size was 9 cm.
- Thirty nine (26.5%) patients with massive ascites 1000 mL on intraoperative evaluation.
- With a median follow-up of 48 months, the median OS after ovarian metastasectomy for all patients was 8.2 months (95% CI 7.2-9.3 months).
- In univariate analyses, extragenital primary cancer site from gastrointestinal cancer compared to that of breast cancer (8.0 months vs. 41.0 months, P=0.000), from gastric cancer compared to that of colorectal cancer (7.4 months vs. 8.8 months, P=0.036), synchronous metastases (8.1 months vs. 10.2 months, P=0.027), local invasion (8.0 months vs. 13.7 months, P=0.007), massive intraoperative ascites ([greater than or equal to] 1000 mL) (6.0 months vs. 9.9 months, P=0.005), combined metastasis (5.9 months vs. 10.2 months, P=0.001) were identified as significant poor prognosis factors.
- In multivariate analyses combined metastasis (RR, 1.72; 95% CI, 1.09-2.69, P=0.018), locally invasion (RR, 1.62; 95% CI, 1.03-2.54, P=0.038) and massive intraoperative ascites (RR, 1.58; 95% CI, 1.02-2.49, P=0.04) were independent factors for predicting unfavorable overall survival.