Diseases of the Colon & Rectum

, Volume 40, Issue 11, pp 1299–1302 | Cite as

Simultaneous bilateral oophorectomy does not improve prognosis of postmenopausal women undergoing colorectal resection for cancer

  • Igor Sielezneff
  • Etienne Salle
  • Kristina Antoine
  • Xavier Thirion
  • Christian Brunet
  • Bernard Sastre
Original Contributions


PURPOSE: Synchronous or metachronous ovarian metastases are common along the natural course of colorectal carcinoma. We attempted to prospectively assess the prognostic impact of simultaneous bilateral oophorectomy in postmenopausal women undergoing curative resection for colorectal cancer. METHODS: Between 1980 and 1990, simultaneous bilateral oophorectomy was proposed in each postmenopausal woman referred to our institution for treatment of colorectal cancer. A subset of 92 patients underwent a curative resection. Therefore, two groups were designed for comparison of the procedure. Group I included 41 patients who accepted surgical castration, and Group II consisted of the 51 remaining patients who refused. Prospective analysis of all patients was performed. Results were assessed with a follow-up of 60 months after surgery, with 97.9 percent completion. Local recurrence and liver metastases rates were compared by the chisquared test. Survival in each group was calculated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: One patient (1/41; 2.4 percent) had ovarian metastases detected on the operative specimen. Local recurrence or liver metastases rates were not affected by oophorectomy (P=0.73;P=0.25). Five-year actuarial survival rates were not significantly different whether patients had oophorectomy (81.6 percent) or not (87.9 percent;P=0.62). CONCLUSIONS: Our results suggest that microscopic synchronous ovarian metastasis is rare at the time of curative resection of a colorectal carcinoma in postmenopausal women. Because simultaneous bilateral oophorectomy does not modify prognosis, this procedure seems to be unwarranted.

Key words

Colorectal carcinoma Ovarian metastases Oophorectomy 


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  1. 1.
    Krükenberg F. Uber das Fibrosarcoma ovarii mucocellulare. Arch Gynakol 1896;50:287–321.Google Scholar
  2. 2.
    Barber HR. Ovarian carcinoma. 1st ed. New York: Masson, 1975.Google Scholar
  3. 3.
    Crespy B, Delpero JR, Carabalona B, Sastre B, Michotey G, Guérinel G. Métastases ovariennes des cancers colorectaux: dix-huit observations. Med Chir Dig 1986;15:54–6.Google Scholar
  4. 4.
    Buirge RE. Carcinoma of the large intestine: review of four hundred and sixteen autopsy records. Arch Surg 1941;42:801–18.Google Scholar
  5. 5.
    Abrahams HL, Spiro R, Goldstein N. Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 1950;3:74–85.PubMedGoogle Scholar
  6. 6.
    Burt CA. Prophylactic oophorectomy with resection of the large bowel for cancer. Am J Surg 1951;82:571–6.PubMedGoogle Scholar
  7. 7.
    Stearns MW Jr, Deddish MR. Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum. Dis Colon Rectum 1959;2:169–72.PubMedGoogle Scholar
  8. 8.
    Antoniades K, Spector HB, Hecksher RH Jr. Prophylactic oophorectomy in conjunction with large-bowel resection for cancer: report of two cases. Dis Colon Rectum 1977;20:506–10.PubMedGoogle Scholar
  9. 9.
    Blamey SL, McDermott FT, Pihl E, Price AB, Milne BJ, Hughes ES. Ovarian involvement in adenocarcinoma of the colon and rectum. Surg Gynecol Obstet 1981;153:42–4.PubMedGoogle Scholar
  10. 10.
    Harcourt KF, Dennis DL. Laparotomy for “ovarian tumors” in unsuspected carcinoma of the colon. Cancer 1968;21:1244–6.PubMedGoogle Scholar
  11. 11.
    O'Brien PH, Newton BB, Metcalf JS, Rittenbury MS. Oophorectomy in women with carcinoma of the colon and rectum. Surg Gynecol Obstet 1981;153:827–30.PubMedGoogle Scholar
  12. 12.
    Cutait R, Lesser ML, Enker WE. Prophylactic oophorectomy in surgery for large-bowel cancer. Dis Colon Rectum 1983;26:6–11.PubMedGoogle Scholar
  13. 13.
    Graffner H, Alm P, Oscarson J. Prophylactic oophorectomy in colorectal carcinoma. Am J Surg 1983;146:233–5.PubMedGoogle Scholar
  14. 14.
    MacKeigan JM, Ferguson JA. Prophylactic oophorectomy and colorectal cancer in premenopausal patients. Dis Colon Rectum 1979;22:401–5.PubMedGoogle Scholar
  15. 15.
    Karsh J. Secondary malignant disease of the ovaries: a study of seventy-two autopsies. Am J Obstet Gynecol 1951;61:154–60.PubMedGoogle Scholar
  16. 16.
    Rodier JF, Janser JC, Rodier D. Métastases ovariennes des cancers colo-rectaux: place actuelle de l'ovariectomie bilatérale prophylactique. Ann Chir 1992;46:932–5.PubMedGoogle Scholar
  17. 17.
    Herrera LO, Ledesma EJ, Natarajan N, Lopez GE, Tsukada Y, Mittelman A. Metachronous ovarian metastases from adenocarcinoma of the colon and rectum. Surg Gynecol Obstet 1982;154:531–3.PubMedGoogle Scholar
  18. 18.
    Morrow M, Enker WE. Late ovarian metastases in carcinoma of the colon and rectum. Arch Surg 1984;119:1385–8.PubMedGoogle Scholar
  19. 19.
    Rendleman DF, Gilchrist RK. Indications for oophorectomy in carcinoma of the gastrointestinal tract. Surg Gynecol Obstet 1959;109:364–6.PubMedGoogle Scholar
  20. 20.
    Burt CA. Carcinoma of the ovaries secondary to cancer of the colon and rectum. Dis Colon Rectum 1960;3:352–7.PubMedGoogle Scholar
  21. 21.
    Quan SH, Sehdev MK. Pelvic surgery concomitant with bowel resection for carcinoma. Surg Clin North Am 1974;54:881–7.PubMedGoogle Scholar
  22. 22.
    Tunca J, Starling J, Hafez G, Buchler D. Colon carcinoma metastatic to the ovary. J Surg Oncol 1983;23:269–72.PubMedGoogle Scholar
  23. 23.
    Barr SS, Valiente MA, Bacon HE. Rationale of bilateral oophorectomy concomitant with resection for carcinoma of the rectum and colon. Dis Colon Rectum 1962;5:450–2.PubMedGoogle Scholar
  24. 24.
    Sherman LF, Tenner RJ, Chadbourn WA. Prophylactic oophorectomy with carcinoma of the rectum and colon. Dis Colon Rectum 1964;7:517–20.Google Scholar
  25. 25.
    Reclade M, Holyoke ED, Elias EG. Carcinoma of the colon, rectum and anal canal in young patients. Surg Gynecol Obstet 1974;139:909–13.PubMedGoogle Scholar
  26. 26.
    Ballantyne G, Reigel M, Wolff B, Ilstrup D. Oophorectomy and colon cancer: impact on survival. Ann Surg 1985;202:209–14.PubMedGoogle Scholar
  27. 27.
    Lorimier G, Reigner B, Rive C, Cronier P, Talha A, Guntz M. Métastases ovariennes des cancers digestifs: démarches diagnostiques et thérapeutiques. J Chir (Paris) 1988;125:699–703.Google Scholar
  28. 28.
    Blamey SL, McDermott FT, Pihl E, Hughes ES. Resected ovarian recurrence from colorectal adenocarcinoma: a study of 13 cases. Dis Colon Rectum 1981;24:272–5.PubMedGoogle Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1997

Authors and Affiliations

  • Igor Sielezneff
    • 1
  • Etienne Salle
    • 1
  • Kristina Antoine
    • 1
  • Xavier Thirion
    • 2
  • Christian Brunet
    • 1
  • Bernard Sastre
    • 1
  1. 1.Department of Digestive SurgeryHÔpital Sainte-MargueriteMarseilleFrance
  2. 2.Department of Medical StatisticsHÔpital Sainte-MargueriteMarseilleFrance

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