LOGO
pl en

Prophylactic ovariectomy in patients with colorectal cancer: is it justified?

Wojciech M. Wysocki1, Zbigniew Kojs2, Jerzy Mituś1, Andrzej Stelmach1

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2013, 11 (1), p. 55–61
DOI: 10.15557/CGO.2013.0005
Streszczenie

The article is a review of available literature concerning the incidence of synchronous and metachronous metastases of colorectal cancer to the ovaries. A separate analysis included data from autopsy and clinical studies (incidence in historic series: 5–10% in the former and 3–14% in the latter). Recent studies estimate the incidence of metastases of large bowel cancer to the ovaries at 0.9–2.9%. At the time of diagnosis, metastasis to the ovary usually takes the form of solid or solid-cystic tumor of over 4 cm in diameter, often bilateral (5–70%). Recent studies did not confirm higher incidence of metastases to the ovaries of tumors located in the rectum versus those located in the colon. Furthermore, we discuss prognostic value of metastases to the ovaries considering current TNM classification, highlighting newly created categories M1a (isolated metastasis, e.g. to the ovary) and M1b (multiple distant metastases). The authors suggest simplified clinical recommendations, advocating against prophylactic ovariectomy of grossly normal ovaries. On the other hand, excision of tumor-invaded ovary in premenopausal women or of both ovaries (diseased and normal contralateral) in postmenopausal women, appears justified. However, before undertaking such a procedure, one must be sure about absence of other tumor foci or – if they are present – about feasibility of complete excision of all other extraovarian metastases.

Słowa kluczowe
colorectal cancer, ovarian metastasis, incidence, prognosis, prophylactic ovariectomy