Clinical, Pathological Analysis Of High Risk Factors In Ovarian Metastases From Colorectal Neoplasm

PurposeWe investigated the clinical,pathological high risk factors of ovarian metastases from colorectal Neoplasm to provide the basis for clinical diagnosis and treatment decision-making.Methods and MaterialsCases of metastatic group in accordance with entry criteria and exclusion criteria were selected from November 1985 to December 2006.They were female colorectal neoplasm inpatients with ovary metastases and undergone with surgical treatment at Fudan University Cancer Hospital.87 cases were included among which 45 cases were synchronia ovarian metastases while the rest 42 were heterochronia ovarian metastases.Cases of the control group in accordance with entry criteria and exclusion criteria were selected from the hospital from January 1990 to December 2000.They were female colorectal neoplasm inpatients and undergone with radical operation.All the 231 cases in the control group were fulfilled with follow-up of three years without ovarian metastases.Keep information of the selected cases in detail including age of primary colorectal cancer,age of ovarian metastases,interval of ovarian metastases, side of ovarian metastases,marriage,menopause status,the original tumor site,the primary histopathological type,differentiation,depth of invasion,the number of lymph node metastases,TNM stage,ER and PR expression,preoperative CEA, P53 expression.Software tools for statistical analysis:SPSS 11.0.We used single-factor analysis and multi-factor analysis to investigate the selected indicators for clinical use.Results:Results of single-factor analysis suggest that there are no significant statistical difference between synchronia ovarian metastases and heterochronia ovarian metastases in the metastatic group.More patients with colorectal neoplasm ovarian metastases are bilateral(50.6%).Patients of colorectal neoplasm with ovarian metastases have such high risk factors as age of onset(less than 60 years old)(p= 0.000),pre-menopausal(p=0.000),unmarried(p=0.000),primary tumors in the colon and rectum near ovary(p=0.000),the primary histologic type (mutinous adenocarcinoma or signet ring cell carcinoma)(p=0.042),poorly differentiated(p=0.000),invasion to the serosa or outside the serosa(T3-4)(p =0.000),positive lymph node metastases(p=0.000).Because of lack of too much data on molecular markers for indication such conclusions are not adopted.Results of multi-factor analysis suggest that age of onset(less than 60 years old), unmarried,primary tumors in the colon and rectum near ovary,mucinous adenocarcinoma or signet ring cell carcinoma,poorly differentiated,T3-4,positive lymph node metastases female patients with colorectal cancer are prone to get ovarian metastases.ConclusionsYoung(less than 60 years old),unmarried,primary tumors in the colon and rectum near ovary,mucinous adenocarcinoma or signet ring cell carcinoma,poorly differentiated,T3-4,positive lymph node metastases female patients with colorectal cancer have high risk factors to get ovarian metastases.It can be regarded as the independent indicator for clinical diagnosis and treatment decision-making.