OVARIAN METASTASIS IN PATIENTS WITH COLORECTAL-CARCINOMA

The records of 159 patients who underwent surgical resection of colore ctal cancer were reviewed to assess the incidence of ovarian metastasi s and to define the role of oophorectomy. Four of these patients prese nted with metachronous metastases, and one patient had synchronous ova rian involvement. The incidence of ovarian involvement was higher in y ounger patients. While most patients with ovarian involvement had the primary tumor located at the rectosigmoid region, a similar distributi on of the primary tumor was observed in patients without ovarian metas tasis. The histological type and degree of differentiation was similar regardless of whether or not ovarian metastasis was present. Of the p atient without ovarian metastasis, 57% presented with nodal metastases and 3.2% with peritoneal dissemination, while all patients with ovari an metastasis had nodal and peritoneal involvement. Our results sugges t that histological type and degree of differentiation of the primary tumor do not influence likelihood of ovarian metastasis. However, the exposure of the tumor to the serosal surface and the subsequent perito neal dissemination may be an important route by which malignant tumor cells reach the ovaries. However, due to the wide lymphatic involvemen t in patients with ovarian metastasis, the lymphatic route may be impo rtant as well. Thus, we consider that oophorectomy should be performed in all postmenopausal women, when the ovaries are macroscopically aff ected, and in premenopausal patients with Astler-Coller B2 tumors or o ver.