Incidence, risk factors, treatment, and survival of ovarian metastases of colorectal origin: a Dutch population-based study

Bakkers, Checca; Meer, R van der; Roumen, R. M. H.; Lurvink, Robin J.; Lemmens, Valery; Erning, Felice N. van; Hingh, Ignace H. J. T. de

doi:10.1007/s00384-020-03555-5

Cited by 16 publications

(23 citation statements)

References 33 publications

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“…In contrast with previous findings, in the current study, well/moderately differentiated adenocarcinoma was the most common pathological type of primary CRC among our patients with OM-CRC (20,22). However, Bakkers et al indicated a positive correlation of the rate of mucinous adenocarcinoma in CRC patients with OM rather than without (10). The influence of age and menstruation on the development and prognosis of OM-CRC has been a controversial topic.…”

Section: Discussioncontrasting

confidence: 99%

“…However, in recent years, several smallscale retrospective studies have indicated that patients with OM-CRC could benefit from resection of the ovary metastasis (6)(7)(8)(9). Compared with metastasis of other sites from CRC, OM-CRC is relatively rare and Bakkers et al suggest that the incidence of OM-CRC was about 0.9% in female CRC patients (10). These innovative findings highlight a potential cure for this relatively rare malignant ovary tumour which is defined as advanced CRC.…”

Section: Original Articlementioning

confidence: 99%

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The clinicopathological characteristics, prognosis, and CT features of ovary metastasis from colorectal carcinoma

Chen¹,

Liu²,

Yang³

et al. 2021

Transl Cancer Res TCR

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Background: The aim of this study was to study patients diagnosed with ovary metastasis from colorectal carcinoma (OM-CRC) regarding their clinical manifestations, pathological characteristics and developments based on the results of computed tomography (CT).Methods: Research was conducted with OM-CRC admissions to our facility during the period of January, 2000 to January, 2020, with examinations of both patients and imaging statistics.Results: A group of 21 female participants with a median age of 54-year-old, ranging from 48 to 68 years old, were investigated. In the univariate analyses, synchronous metastasis and R2 resection (macroscopic residual lesions) during cytoreductive surgery (CRS) were shown to be negatively associated with the OM-CRC prognosis. Results of the multivariate analysis showed that R2 resection during CRS was the only independent predictor of the overall survival (OS) rate as well as the progression-free survival (PFS) rate.OM-CRC cases frequently exhibited a well-defined borderline (90.9%), predominantly cystic ovarian mass (90.9%), heterogeneous enhancement (72.3%), moderate enhancement (63.6%), peritoneal implantation (81.8%) and an absence of lymphadenopathy (90.9%). Conclusions:It is important to develop a thorough comprehension of the pathological characteristics as well as developments of OM-CRC, in order to understand its diagnosis, develop useful therapeutic interventions, and predict accurate prognosis. Nevertheless, OM-CRC is an uncommon malignant ovarian tumor and a good prognosis requires a CRS without macroscopic residual lesions, as a significant finding of our study.

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Section: Discussioncontrasting

confidence: 99%

Section: Original Articlementioning

confidence: 99%

The clinicopathological characteristics, prognosis, and CT features of ovary metastasis from colorectal carcinoma

Chen¹,

Liu²,

Yang³

et al. 2021

Transl Cancer Res TCR

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“…It could be hypothesized though, that probably a more vulnerable group of patients with extensive disease is included in the sample without OM, which impacts the comparison of both samples. Several retrospective studies suggest that ovarian metastasectomy or palliative surgery may positively affect survival in patients suffering from OM 4,25‐28 . Even when cure is no longer possible, it has been suggested that a “palliative oophorectomy” could improve survival or prevent large symptomatic OM 5‐7,26,29 .…”

Section: Discussionmentioning

confidence: 99%

A propensity score‐matched analysis of oncological outcome after systemic therapy for stage IV colorectal cancer: Impact of synchronous ovarian metastases

Meer

Bakkers

Erning

et al. 2022

Intl Journal of Cancer

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The reported incidence of synchronous and metachronous ovarian metastases (OM) from colorectal cancer (CRC) is $3.4%. OM from CRC are often considered sanctuary sites due to their lower sensitivity to systemic treatment. It has thus been hypothesized that the presence of OM decreases overall survival. Therefore, the purpose of our study was to evaluate the impact of synchronous OM on overall survival in female patients with stage IV CRC treated with systemic therapy alone with palliative intent. The present study used data from the Netherlands Cancer Registry and included female CRC patients with synchronous systemic metastases who were treated with systemic therapy between 2008 and 2018. A subsample was created using propensity score matching to create comparable groups. Propensity scores were determined using a logistic regression model in which the dependent variable was the presence of OM and the independent variables were the variables that differed significantly between both groups. Our study included 5253 patients with stage IV CRC that received systemic therapy. Among these patients, 161 (3%) had OM while 5092 (97%) had extra-ovarian metastases only. Three-year overall survival rates did not show a significant difference between patients with OM compared to patients without ovarian metastases. Moreover, the propensity score-matched analysis showed that the presence of OM in patients treated with systemic therapy for stage IV CRC disease was not associated with decreased 3-year overall survival. However, the results of the present study should be interpreted with caution, due to its observational character and used selection criteria.

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“…The risk of developing OM in patients with CRC has been reported as between 1–8% [ 1 , 3 – 5 , 8 , 11 – 16 ], with postmortem studies showing a higher incidence of 5–10% [ 2 ]. Review of the literature by Pitt et al [ 17 ] revealed the mean risk for development of synchronous and metachronous OM is 3.4%.…”

Section: Introductionmentioning

confidence: 99%

“…Intra-abdominal relapse of colorectal cancer (CRC), including ovarian metastases (OM), is a serious event leading to high morbidity and mortality and to a significant loss in quality of life [1,2]. For CRC patients with OM, including those who are operated with curative intent, the reported median survival is between 12-18 months [1,[3][4][5] and the 5-year survival rate is about 12-27% [2,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Role Of Ovarian Metastases In Colorectal Cancer (ROMIC): a Dutch study protocol to evaluate the effect of prophylactic salpingo-oophorectomy in postmenopausal women

et al. 2022

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Background The mean incidence of ovarian metastases (OM) in patients with colorectal cancer (CRC) is 3.4%. The 5-year survival of these patients, even when operated with curative intent, is remarkably low. The lifetime risk of ovarian cancer is approximately 1.3%. Prophylactic salpingo-oophorectomy (PSO, or surgical removal of the ovaries and fallopian tubes) could reduce the number of CRC patients that develop OM after removal of the primary tumor, as well as preventing the occurrence of primary ovarian cancer. Recently, the care pathway for CRC has been changed in several hospitals in line with the updated Dutch guideline. The possibility of PSO is now discussed with postmenopausal CRC patients in these hospitals. The aims of the current study are firstly to estimate the incidence of OM and primary ovarian cancer in postmenopausal patients with CRC, and secondly to evaluate the effect of PSO in these patients. Methods An information bulletin and decision guide on this topic was implemented in several Dutch hospitals in 2020. Post-decision outcomes will be collected prospectively. The study population consists of postmenopausal (≥ 60 years of age) patients that are operated with curative intent for CRC. Based on their own preference, patients will be divided into two groups: those who choose to undergo PSO and those who do not. The main study parameters are the reduction in incidence of ovarian malignancies (metastatic or primary) following PSO, and the number needed to treat (NNT) by PSO to prevent one case of ovarian malignancy. Discussion This will be the first study to evaluate the effect of PSO in postmenopausal CRC patients that is facilitated by an altered CRC care pathway. The results of this study are expected to provide relevant information on whether PSO adds significant value to postmenopausal patients with CRC. Trial registration International Clinical Trials Registry Platform, NL7870. Registered on 2019 July 12. URL of trial registry record: https://trialsearch.who.int/Trial2.aspx?TrialID=NL7870. Protocol version: 1.0, date 2021 June 8.

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Incidence, risk factors, treatment, and survival of ovarian metastases of colorectal origin: a Dutch population-based study

Cited by 16 publications

References 33 publications

The clinicopathological characteristics, prognosis, and CT features of ovary metastasis from colorectal carcinoma

The clinicopathological characteristics, prognosis, and CT features of ovary metastasis from colorectal carcinoma

A propensity score‐matched analysis of oncological outcome after systemic therapy for stage IV colorectal cancer: Impact of synchronous ovarian metastases

Role Of Ovarian Metastases In Colorectal Cancer (ROMIC): a Dutch study protocol to evaluate the effect of prophylactic salpingo-oophorectomy in postmenopausal women

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