SIMULTANEOUS BILATERAL OOPHORECTOMY DOES NOT IMPROVE PROGNOSIS OF POSTMENOPAUSAL WOMEN UNDERGOING COLORECTAL RESECTION FOR CANCER

PURPOSE: Synchronous or metachronous ovarian metastases are common alo ng the natural course of colorectal carcinoma. We attempted to prospec tively assess the prognostic impact of simultaneous bilateral oophorec tomy in postmenopausal women undergoing curative resection for colorec tal cancer. METHODS: Between 1980 and 1990, simultaneous bilateral oop horectomy was proposed in each postmenopausal woman referred to our in stitution for treatment of colorectal cancer. A subset of 92 patients underwent a curative resection. Therefore, two groups were designed fo r comparison of the procedure. Group I included 41 patients who accept ed surgical castration, and Group II consisted of the 51 remaining pat ients who refused. Prospective analysis of all patients was performed. Results were assessed with a follow-up of 60 months after surgery, wi th 97.9 percent completion. Local recurrence and liver metastases rate s were compared by the chi-squared test. Survival in each group was ca lculated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: One patient (1/41; 2.4 percent) had ovarian metastases detec ted on the operative specimen. Local recurrence or liver metastases ra tes were not affected by oophorectomy (P = 0.73; P = 0.25). Five-year actuarial survival rates were not significantly different whether pati ents had oophorectomy (81.6 percent) or not (87.9 percent; P = 0.62). CONCLUSIONS: Our results suggest that microscopic synchronous ovarian metastasis is rare at the time of curative resection of a colorectal c arcinoma in postmenopausal women. Because simultaneous bilateral oopho rectomy does not modify prognosis, this procedure seems to be unwarran ted.