title: Ovarian metastasis is associated with retroperitoneal lymph node relapses in women treated for colorectal peritoneal carcinomatosis.
abstract: OBJECTIVE
  To analyze the patterns of recurrence and the prognostic impact of ovarian metastases (OM) in a population of women with colorectal peritoneal carcinomatosis (CRPC) treated with curative intent.
  
  
  METHODS
  Data from all consecutive women with CRPC who underwent curatively intended complete cytoreductive surgery (CRS) plus intraperitoneal chemotherapy at our institution were retrieved from a prospective database. A bilateral oophorectomy or a complementary unilateral oophorectomy was systematically performed during CRS.
  
  
  RESULTS
  From 1994 to 2009, among 105 women who underwent CRS plus intraperitoneal chemotherapy for CRPC, 62 (60 %) had OM. Women with and without OM had comparable peritoneal cancer index (PCI) scores (10 vs. 12, respectively, p = 0.09). After a median follow-up of 60 (range 5-145) months, median overall survival of women with OM did not differ statistically from that of women without OM (respectively, 36 and 40 months; p = 0.75). Relapses occurred in 82 % of the patients, distributed similarly between the two groups except for retroperitoneal lymph node recurrence, which occurred in 19 patients (18 %), including 18 with OM. The only predictive factor for a retroperitoneal relapse was a history of OM (p = 0.0012).
  
  
  CONCLUSIONS
  Retroperitoneal lymph node recurrence seems to be linked to OM originating from colorectal cancer and could worsen the prognosis. A systematic lymphadenectomy could be evaluated in women with isolated OM or very limited peritoneal carcinomatosis to analyze the incidence of invaded lymph nodes and study its potential benefit on survival.
authors.affiliation: Department of Surgical Oncology, Institut Gustave Roussy, Villejuif Cedex, France. clarisse.eveno@gmail.com
authors.forename: Clarisse
authors.initials: C
authors.lastname: Eveno
authors.forename: Diane
authors.initials: D
authors.lastname: Goéré
authors.forename: Peggy
authors.initials: P
authors.lastname: Dartigues
authors.forename: Charles
authors.initials: C
authors.lastname: Honoré
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dumont
authors.forename: Dimitri
authors.initials: D
authors.lastname: Tzanis
authors.forename: Léonor
authors.initials: L
authors.lastname: Benhaim
authors.forename: David
authors.initials: D
authors.lastname: Malka
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult
chemical_list: D016685:Mitomycin; D004317:Doxorubicin; D005472:Fluorouracil