title: The role of cytoreductive surgery for colon cancer metastatic to the ovary.
abstract: OBJECTIVE
  We sought to further elucidate the survival impact of cytoreductive surgery among patients with colon cancer metastatic to the ovary.
  
  
  METHODS
  All women diagnosed with primary colon cancer metastatic to the ovary at a single institution from 1980 to 2005 were retrospectively identified. Survival analyses and comparisons were performed using Kaplan-Meier plots and the log rank test.
  
  
  RESULTS
  A total of 39 patients with 40 cases of colon cancer metastatic to the ovary were identified. Patients with metastatic disease confined to the ovaries (n=11) had a median overall survival (OS) time of 61 months (range 15-120) compared to 17 months (range 0.5-73) for those with more extensive metastases (n=24) (p=0.0428). Patients undergoing optimal cytoreduction (residual < or =1 cm) had a median progression-free survival (PFS) of 11 months (range 0.5-120, n=26) compared to 2.5 months (range 0.5-12, n=9) for those receiving suboptimal cytoreduction (p=0.0001). Optimal cytoreduction was also associated with a significantly longer median OS (35 months, range 0.5-120) compared to suboptimal cytoreduction (median OS=7 months, range=0.5-17) (p<0.0001). The peri-operative mortality rate was 5%. Significant morbidity occurred in 10% of the cases. All major complications occurred in women with diffuse disease who underwent extensive cytoreductive surgery.
  
  
  CONCLUSIONS
  The observation that optimal cytoreduction was associated with prolonged PFS and OS in both patients with localized ovarian and widespread metastases of colon cancer suggests a role for surgical management of metastatic colon cancer in women.
authors.affiliation: Department of Gynecology and Obstetrics, Kelly Gynecologic Oncology Service, The Johns Hopkins Hospital, Baltimore, MD 21287, USA. cmccorm1@jhmi.edu
authors.forename: Colleen C
authors.initials: CC
authors.lastname: McCormick
authors.forename: Robert L
authors.initials: RL
authors.lastname: Giuntoli
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Gardner
authors.forename: Richard D
authors.initials: RD
authors.lastname: Schulick
authors.forename: Kara
authors.initials: K
authors.lastname: Judson
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Ronnett
authors.forename: Russell
authors.initials: R
authors.lastname: Vang
authors.forename: Robert E
authors.initials: RE
authors.lastname: Bristow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate