International Journal of Hematology and Oncology 2024, Vol 34, Num 1 Page(s): 110-115
Cytoreductive Surgery for Intestinal Cancer Patients Metastatic to Ovaries Presenting as Primary Ovarian Cancer

Zafer ARIK1, Murat OZ1, Omer DIZDAR2, M. Emre YILDIRIM1, Emre OZGU1, S. Gokay TERZIOGLU3, Tayfun GUNGOR1

1Zekai Tahir Burak Women’s Health Training and Research Hospital, Department of Medical Oncology, Ankara, TURKEY
2Hacettepe University, Cancer Institute, Department of Medical Oncology, Ankara, TURKEY
3Ankara Numune Training and Research Hospital, Department of General Surgery, Ankara, TURKEY

Keywords: Cytoreductive surgery, Nongenital cancer, Ovary, Colon cancer
Colorectal cancer accounts for one third of non-genital tumors metastasize to ovaries. We aimed to investigate the role of cytoreductive surgery in colon and small intestine cancer patients with adnexal metastases, which were operated as primary epithelial ovarian cancer. This analysis included 26 patients with adnexal metastasis from colon and distal ileum, which were presented as primary ovarian cancer and operated in Zekai Tahir Burak Women’s Health Hospital, Gynecologic Oncology Unit between 2008 and 2014. Patients with the history of intestinal cancers were not included in the study. The median age of patients was 54 (range= 26-77). Among all patients, 63% were premenopausal and 37% were postmenopausal. Most common presenting symptom was abdominal distention (80%). Optimal cytoreduction was performed in 21 patients. Right hemicolon was the primary site of the tumor in 8 patients, while recto-sigmoid and appendiceal tumors were present in 7 and 7 patients, respectively. Isolated ovarian metastases were found in 6 patients, the remaining 20 patients had peritoneal carcinomatosis. Median follow-up was 25 months (ranging 3-59). In total, 11 patients died, of them, two patients had isolated ovarian metastasis, while remaining nine patients had peritoneal carcinomatosis. Estimated median overall survival was 36.8 months (95% CI= 28.6-45.1 months). Median overall survival of patients who underwent cytoreductive surgery was not reached (36.8+ months), compared with 18.3 (95% CI= 0.0-46.4) months for patients with suboptimal cytoreductive surgery (p= 0.008). This retrospective study showed that cytoreductive surgery might have beneficial effect in selected patients with intestinal cancer metastatic to the adnexal.