title: Treatment of ovarian metastases of colorectal and appendiceal carcinoma in the era of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
abstract: OBJECTIVE
  To compare outcome of women with ovarian metastasis who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) to outcome of women without ovarian metastasis who underwent CRS-HIPEC.
  
  
  METHODS
  A prospective CRS-HIPEC database was searched to identify women with surgically treated colorectal carcinoma between 2000 and 2012. Patients with ovarian metastasis were identified and patients with peritoneal carcinomatosis but without ovarian metastasis were included as control cases.
  
  
  RESULTS
  75 patients with macroscopic ovarian metastasis underwent CRS-HIPEC with curative intent, while 50 female patients without ovarian metastasis were identified who underwent CRS-HIPEC. Patients with ovarian metastasis more often had a primary appendiceal tumour and had a more extensive intra-abdominal tumour load compared to patients without ovarian metastases. Median follow-up time was 45 months (95% confidence interval (CI): 37-53 months). Overall survival (OS) did not differ significantly between the two groups with a median OS in the ovarian metastasis group of 40 months (95% CI 26-54) compared to 64 months (95% CI 17-111, P = 0.478) in the non-ovarian metastasis group. Recurrence patterns did not differ significantly between groups (p = 0.183).
  
  
  CONCLUSIONS
  Patients with ovarian metastasis of colorectal and appendiceal origin who underwent CRS-HIPEC had similar outcome compared to patients without ovarian metastasis. Given the findings of high coincidence of peritoneal metastases with ovarian metastases and ovarian metastases not being an independent factor for survival after CRS-HIPEC, this procedure should be recommended for patients with peritoneal metastases and ovarian metastases of colorectal and appendiceal carcinoma.
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Electronic address: a.kuijpers@nki.nl.
authors.forename: A M J
authors.initials: AM
authors.lastname: Kuijpers
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Mehta
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: A G J
authors.initials: AG
authors.lastname: Aalbers
authors.affiliation: Department of Oncological Gynecology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: van Driel
authors.affiliation: Department of Gastro-enterology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Boot
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: V J
authors.initials: VJ
authors.lastname: Verwaal
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001063:Appendiceal Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D010529:Peritoneal Cavity; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Colorectal carcinoma; Cytoreduction; HIPEC; Ovarian metastasis; Peritoneal; Surgery