Prophylactic ovariectomy in patients with colorectal cancer: is it justified?
Affiliation and adress for correspondence

1 Klinika Chirurgii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie
2 Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie
Correspondence to: Dr n. med. Wojciech Wysocki, Klinika Chirurgii Onkologicznej, Centrum Onkologii – Instytut
im. Marii Skłodowskiej-Curie, Oddział w Krakowie, ul. Garncarska 11, 31-115 Kraków, tel.: 12 422 49 28, e-mail: z5wysock@cyf-kr.edu.pl
The article is a summary and further development of a presentation given at the conference “Progress in Oncological Gynecology” held in Kocierz
near Andrychów in September 2012.
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2013, 11 (1), p. 55–61
DOI: 10.15557/CGO.2013.0005
ABSTRACT

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.

Keywords: colorectal cancer, ovarian metastasis, incidence, prognosis, prophylactic ovariectomy