Ovarian colorectal metastases: peritoneal or hematogeneous metastatic disease?

Autor: M. Leimkühler, P.H.J. Hemmer, N. Werner, I.H.J.T. de Hingh, M.J.E. Mourit, H. Hollema, G.H. de Bock, B.L. van Leeuwen
Rok vydání: 2022
DOI: 10.21203/rs.3.rs-1684313/v1
Popis: PurposeThere is an ongoing discussion whether ovarian colorectal metastases are the result of peritoneal or hematogeneous dissemination. The metastatic route has implications on the choice of treatment. This study aims to evaluate and discuss the factors indicating peritoneal or hematogenic dissemination and aims to evaluate and discuss the factors indicating peritoneal or haematogenic spreadMethodsA retrospective consecutive series of patients from two tertiary referral centers, who were treated for ovarian metastases from colorectal cancer between 2000 and 2018, was described. Clinical and histopathological characteristics of the primary tumor and the ovarian metastases were collected from patient files, the surgery reports and the pathology files. Statistical analysis included descriptive statistics, whereas binominal testing was used to compare the likelihood of two categories.ResultsData of 141 patients were included. In most cases the ovarian capsule (73.6%) was broken and 120 patients (85.1%) had peritoneal metastases at the time of diagnosis of the ovarian metastases. Most metastatic cells were found deep in the ovarian stroma (80.0%) and 26.2% of patients developed metachronous hematogeneous (distant and/or liver) metastases. ConclusionsIn this study we found characteristics that support a peritoneal as well as a hematogenous dissemination. Therefore, an undoubted conclusion regarding the metastatic route cannot be drawn. Future studies should focus on the biological behavior as well as on the outcome of patients with ovarian metastases after CRS+HIPEC to evaluate its added value in this patient group.
Databáze: OpenAIRE