PROPHYLACTIC OOPHORECTOMY IN COLORECTAL-CARCINOMA - PRELIMINARY-RESULTS OF A RANDOMIZED, PROSPECTIVE TRIAL

Controversy exists regarding the role of prophylactic oophorectomy dur ing resection for primary colorectal cancer. PURPOSE: A prospective, r andomized trial was initiated to evaluate the influence of oophorectom y on recurrence and survival in patients with Dukes Stages B and C col orectal cancer. METHOD: Between November 1986 and March 1997, 155 pati ents were randomized to oophorectomy or no oophorectomy at laparotomy for resection of colorectal cancer. RESULTS: No incidence of gross or microscopic metastatic disease to the ovary was found among 77 patient s randomized to oophorectomy, in contrast to previous reports. Prelimi nary crude survival curves suggested a survival benefit for oophorecto my between two and three years from surgery, but Kaplan-Meier survival analysis indicated that this was not statistically significant and th e benefit does not appear to persist at five years. Kaplan-Meier curve s of recurrence-free survival, however, suggest a more substantial sep aration of the curves, with 80 percent vs. 65 percent five-year diseas e-free survival for oophorectomy us. nonoophorectomy, but further pati ent accrual is necessary to provide sufficient statistical power. CONC LUSIONS: Occult colorectal carcinoma metastatic to the ovaries has not been documented in this series of putative Dukes Stages B and C tumor s. The possibility of a recurrence-free survival advantage emphasizes the need to continue this preliminary work.