Ovarian metastases resection from extragenital primary sites: outcome and prognostic factor analysis of 147 patients

BMC Cancer

Research Article

Huaying Wang¹  Wenhua Li²  Xiaodong Zhu²  Fangfang LV²  Zhonghua Wang³  Jian Wang⁴ 

[1] Department of Gynecologic Oncology, Cancer Hospital of Fudan University, Shanghai Medical College, Shanghai, P.R. China;Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai Medical College, Shanghai, P.R. China;Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai Medical College, Shanghai, P.R. China;Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai Medical College, No. 270 Dongan Road, 200032, Shanghai, China;Department of Pathology, Cancer Hospital of Fudan University, Shanghai Medical College, Shanghai, P.R. China;

关键词: Median Overall Survival;    Primary Tumor Site;    Signet Ring Cell Carcinoma;    Ovarian Metastasis;    Primary Ovarian Cancer;   

DOI  :  10.1186/1471-2407-12-278

 received in 2012-03-03, accepted in 2012-06-26,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTo explore the outcomes and prognostic factors of ovarian metastasectomy intervention on overall survival from extragenital primary cancer.MethodsPatients with ovarian metastases from extragenital primary cancer confirmed by laparotomy surgery and ovarian metastases resection were retrospectively collected in a single institution during an 8-year period. A total of 147 cases were identified and primary tumor sites were colorectal region (49.0%), gastric (40.8%), breast (8.2%), biliary duct (1.4%) and liver (0.7%). The pathological and clinical features were evaluated. Patients’ outcome with different primary tumor sites and predictive factors for overall survival were also investigated by univariate and multivariate analysis.ResultsMetachronous ovarian metastasis occurred in 92 (62.6%) and synchronous in 55 (37.4%) patients. Combined metastases occurred in 40 (27.2%). Bilateral metastasis was found in 97 (66%) patients. The median ovarian metastasis tumor size was 9 cm. There were 39 (26.5%) patients with massive ascites ≥ 1000 mL on intraoperative evaluation. With a median follow-up of 48 months, the median OS after ovarian metastasectomy for all patients was 8.2 months (95% CI 7.2-9.3 months). In univariate analyses, there is significant (8.0 months vs. 41.0 months, P = 0.000) difference in OS between patients with gastrointestinal cancer origin from breast origin, and between patients with gastric origin from colorectal origin (7.4 months vs. 8.8 months, P = 0.036). In univariate analyses, synchronous metastases, locally invasion, massive intraoperative ascites (≥ 1000 mL), and combined metastasis, were identified as significant poor prognostic factors. In multivariate analyses combined metastasis (RR, 1.72; 95% CI, 1.09-2.69, P = 0.018), locally invasion (RR, 1.62; 95% CI, 1.03-2.54, P = 0.038) and massive intraoperative ascites (RR, 1.58; 95% CI, 1.02-2.49, P = 0.04) were independent factors for predicting unfavorable overall survival.ConclusionOvarian metastases are more commonly originated from primary gastrointestinal tract. The prognosis of ovarian metastasis is dismal and the benefit of ovarian metastatectomy is limited. Combined metastasis outside ovaries, locally invasion and massive intraoperative ascites were independent factors for predicting unfavorable overall survival. The identification of the primary tumor is required to plan for adequate treatment for this group of patients.

【 授权许可】

Unknown   
© Li et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.