The role of cytoreductive surgery for colon cancer metastatic to the ovary.
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.
McCormick
Colleen C
CC
Department of Gynecology and Obstetrics, Kelly Gynecologic Oncology Service, The Johns Hopkins Hospital, Baltimore, MD 21287, USA. cmccorm1@jhmi.edu
Giuntoli
Robert L
RL
Gardner
Ginger J
GJ
Schulick
Richard D
RD
Judson
Kara
K
Ronnett
Brigitte M
BM
Vang
Russell
R
Bristow
Robert E
RE
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