- 期刊
Synchronous Ovarian Metastasis from Colorectal Cancer: Characteristics and Long-term Survival Analysis
同時性大腸直腸癌卵巢轉移臨床表現及術後存活分析
摘要
Purpose. Ovarian metastasis (OM) occurs in patients with colorectal cancer (CRC). The current study aimed to evaluate the characteristics and prognosis of patients with synchronous OM from CRC and to establish an optimal management plan. Methods. We performed a single-center retrospective review. From January 2001 to December 2012, 2191 female patients were diagnosed with primary CRC in our institution. The data of 62 patients with synchronous OM who underwent primary tumor resection and oophorectomy were collected for analysis. Then, the patients' clinicopathological characteristics and prognosis were analyzed. Results. The median age at diagnosis was 50 (range: 26-81) years. The median survival time after surgery was 14 (95% confidence interval: 12- 25) months. None of the patients presented with less than T3 tumor, and almost all patients had an N-positive tumor. In total, 53 (86%) patients had moderately differentiated adenocarcinoma; 2 (3%), poorly differentiated adenocarcinoma; and 7 (11%), mucinous adenocarcinoma. Moreover, 35 (56%) patients experienced bilateral ovarian involvement. Curative resection (R0) was achieved in 15 (24%) patients. The peritoneum (45%) was the most common concurrent metastatic site, followed by the liver (42%) and retroperitoneal lymph nodes (16%). Compared with R1 or R2 resection, R0 resection was associated with a better prognosis (38 vs. 12months; hazard ratio: 0.3; p = 0.0165) in a multivariate analysis. Conclusions. Although OM from CRC is associated with poor outcomes, curative resection may significantly improve overall survival.
並列摘要
目的：評估大腸直腸癌合併同時性卵巢轉移的病人的臨床表現及不同治療方式預後。方法：回朔性分析單一醫學中心自2001年1月至2012年12月共2192名被診斷大腸直腸癌之女性患者，共62位病患合併有同時性卵巢轉移併接受手術切除被納入分析。結果：病患族群平均年齡為50歲，平均術後存活時間為14個月（95％信賴區間：12－25月）。所有病患腫瘤侵犯程度均為T3以上，且幾乎都有淋巴結轉移。有15（24％）位病患接受治癒性（R0）切除。最常見同時合併有轉移的位置依序為腹膜，肝臟及後腹腔淋巴結。在多變數分析中，治癒性切除與非治癒性切除相較之下有較佳的預後及總存活期（38 vs. 12月，風險比率0.3，p = 0.0165）。結論：儘管大腸直腸癌合併卵巢轉移預後差，但我們的研究結果顯示治癒性切除對於總存活期有顯著的幫助。
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