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Eur J Surg Oncol ; 40(8): 937-42, 2014 Aug.
Article de Anglais | MEDLINE | ID: mdl-24630923

RÉSUMÉ

AIM: To compare outcome of women with ovarian metastasis who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) to outcome of women without ovarian metastasis who underwent CRS-HIPEC. METHODS: A prospective CRS-HIPEC database was searched to identify women with surgically treated colorectal carcinoma between 2000 and 2012. Patients with ovarian metastasis were identified and patients with peritoneal carcinomatosis but without ovarian metastasis were included as control cases. RESULTS: 75 patients with macroscopic ovarian metastasis underwent CRS-HIPEC with curative intent, while 50 female patients without ovarian metastasis were identified who underwent CRS-HIPEC. Patients with ovarian metastasis more often had a primary appendiceal tumour and had a more extensive intra-abdominal tumour load compared to patients without ovarian metastases. Median follow-up time was 45 months (95% confidence interval (CI): 37-53 months). Overall survival (OS) did not differ significantly between the two groups with a median OS in the ovarian metastasis group of 40 months (95% CI 26-54) compared to 64 months (95% CI 17-111, P = 0.478) in the non-ovarian metastasis group. Recurrence patterns did not differ significantly between groups (p = 0.183). CONCLUSIONS: Patients with ovarian metastasis of colorectal and appendiceal origin who underwent CRS-HIPEC had similar outcome compared to patients without ovarian metastasis. Given the findings of high coincidence of peritoneal metastases with ovarian metastases and ovarian metastases not being an independent factor for survival after CRS-HIPEC, this procedure should be recommended for patients with peritoneal metastases and ovarian metastases of colorectal and appendiceal carcinoma.


Sujet(s)
Protocoles de polychimiothérapie antinéoplasique/administration et posologie , Tumeurs de l'appendice/anatomopathologie , Carcinomes/traitement médicamenteux , Carcinomes/chirurgie , Tumeurs colorectales/anatomopathologie , Tumeurs de l'ovaire/traitement médicamenteux , Tumeurs de l'ovaire/chirurgie , Tumeurs du péritoine/traitement médicamenteux , Tumeurs du péritoine/chirurgie , Adulte , Sujet âgé , Carcinomes/métabolisme , Traitement médicamenteux adjuvant , Perfusion régionale de chimiothérapie anticancéreuse/méthodes , Bases de données factuelles , Survie sans rechute , Femelle , Études de suivi , Humains , Hyperthermie provoquée , Estimation de Kaplan-Meier , Mâle , Adulte d'âge moyen , Stadification tumorale , Tumeurs de l'ovaire/métabolisme , Cavité péritonéale , Tumeurs du péritoine/métabolisme , Études prospectives , Études rétrospectives , Résultat thérapeutique
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