title: Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites.
abstract: OBJECTIVE
  The purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.
  
  
  METHODS
  All patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients' medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.
  
  
  RESULTS
  The primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph nodes, bladder, or the intestine. With a median follow-up of 33 months, the median survival time was 22 months. The estimated 5-year survival probability is 0.26. On univariate analysis, primary cancer site, combined metastasis outside the ovaries, residual disease, preoperative serum CA 125 and CA 19-9 levels, and histologic type were significant parameters for overall survival. Furthermore, residual disease, preoperative serum CA 19-9 level, and primary cancer site were found to be independent prognostic factors on multivariate analysis.
  
  
  CONCLUSIONS
  The most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.
authors.affiliation: *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa Faculty of Medicine; and †Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
authors.forename: Veysel
authors.initials: V
authors.lastname: Sal
authors.forename: Fuat
authors.initials: F
authors.lastname: Demirkiran
authors.forename: Samet
authors.initials: S
authors.lastname: Topuz
authors.forename: Ilker
authors.initials: I
authors.lastname: Kahramanoglu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yalcin
authors.forename: Tugan
authors.initials: T
authors.lastname: Bese
authors.forename: Hamdullah
authors.initials: H
authors.lastname: Sozen
authors.forename: Nedim
authors.initials: N
authors.lastname: Tokgozoglu
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Salihoglu
authors.forename: Hasan
authors.initials: H
authors.lastname: Turan
authors.forename: Cem
authors.initials: C
authors.lastname: Iyibozkurt
authors.forename: Tugba
authors.initials: T
authors.lastname: Kolomuc
authors.forename: Nigar
authors.initials: N
authors.lastname: Sofiyeva
authors.forename: Sinan
authors.initials: S
authors.lastname: Berkman
authors.forename: Macit
authors.initials: M
authors.lastname: Arvas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult