Clinical Characteristics and Outcomes of Ovarian Metastasis from Colorectal Cancer: A Single-center Experience

結直腸癌卵巢轉移的臨床特徵與預後分析：單中心經驗

許君豪(Jiun-Haur Hsu) ； 陳建勳(Jian-Syun Chen) ； 林秉緯(Ping-Wei Lin) ； 賴正大(Cheng-Ta Lai) ； 蔡柏立(Po-Li Tsai) ； 楊靖國(Ching-Kuo Yang) ； 梁偉雄(Wai-Hung Leung) ； 劉建國(Chien-Kuo Liu) ； 陳明仁(Ming-Jen Chen) ； 許希賢(Hsi-Hsien Hsu) ； 孫文俊(Wen-Chun Sun)

《中華民國大腸直腸外科醫學會雜誌》 33卷2期 (2022/06) Pp. 76-83

https://doi.org/10.6312/SCRSTW.202206_33(2).11111

摘要

Purpose. The current study aimed to analyze the characteristics and outcomes of patients with colorectal cancer and ovarian metastasis. Methods. We reviewed the data of all patients with confirmed ovarian metastasis from colorectal cancer who underwent surgical resection at the Mackay Memorial Hospital between January 2007 and December 2020. A total of 28 patients were enrolled in the study: 17 with synchronous metastases and 11 with metachronous ovarian metastases. The patients' clinical characteristics and prognoses were analyzed. Results. The mean age at diagnosis of the patients with ovarian metastases was 52.1 years. The average overall survival time after surgery was 31.3 ± 9.48 months. The percentage of patients with synchronous and metachronous metastases was 61% and 39%, respectively. The average detection interval of the metachronous metastases was 22.3 months. Slightly elevated serum carcinoembryonic antigen and cancer antigen 125 levels (6.57 ng/mL and 19.14 U/mL, respectively) were observed in the metachronous group. Optimal resection (R0) was achieved in 17 (61%) patients. The peritoneum (43%) was the most common site of concurrent metastasis, followed by the liver (21%). Compared with R1 and R2 resections, patients who underwent R0 resections had significantly improved overall survival (p = 0.023). Conclusions. Metastatic ovarian tumors in the colorectal region are rare and have poor survival outcomes. The levels of carcinoembryonic antigen or cancer antigen 125 may not be very accurate in demonstrating the presence of metachronous ovarian metastasis. Although the prognosis is not optimistic, curative resection can significantly improve patients' overall survival.

關鍵字

Colorectal cancer ； Ovarian metastasis ； Prognosis

並列摘要

介紹：分析大腸直腸癌合併卵巢轉移病人的臨床特徵及預後。方法：回朔性分析單一醫學中心自2007年1月至2020年12月，期間共28位女性病患被診斷大腸直腸癌合併有卵巢轉移並接受手術切除被納入研究。結果：共28位病患平均年齡為52.1歲，平均術後存活時間為31.3個月。其中17位（61%）病患為同時性卵巢轉移，另外11位（39%）為異時性轉移性卵巢轉移。平均發生轉移性卵巢轉移的時間為22.3月及術前的CEA和CA-125分別為6.57 ng/mL和19.14 U/mL。有17（61%）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及肝臟。在多變數分析中，治癒性切除相較非治癒性切除有顯著的較好預後及整體存活率（55 vs. 12月，p = 0.023）。結論：儘管大腸直腸癌合併卵巢轉移的病人預後較差，且CEA和C-125也不是一個很好的追蹤卵巢轉移的指標，但我們的研究結果顯示治癒性切除能顯著的提高病人的整體存活率。

並列關鍵字

大腸直腸癌 ； 卵巢轉移 ； 預後

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