Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde klinikopatolojik özellikler ve prognoz
Abstract
Amaç: Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde klinikopatolojik özellikler ve prognozun araştırılması.
Gereç ve yöntemler: Bu çalışma, Ocak 2015 ile Aralık 2021 tarihleri arasında tek bir merkezde ameliyat edilen, senkron veya metakron tanı konmuş, jinekolojik olmayan primer bölgelerden over metastazı olan ardışık hastaları içeren retrospektif bir çalışmadır. Hastaların klinikopatolojik özellikleri hasta dosyalarından ve elektronik veri tabanından elde edilmiş ve Cox orantılı hazard modelleri kullanılarak analiz edilmiştir.
Bulgular: Cerrahi uygulanan 291 malign over tümöründen 33’ünde (%11.3) jinekolojik olmayan primer bölgelerden overe metastaz tanısı saptandı. En sık primer tümör bölgeleri sırası ile kolorektum (%45.5), mide (%15.2) ve meme (%12.1) idi. Hastaların çoğunda ameliyat öncesi serum Ca-125 düzeyleri yüksekti (%71.4); yaklaşık yarısında senkron over metastazı (%48.5); yaklaşık üçte birinde peritoneal tutulum (%36.4) ve/veya asit (%30.3) mevcuttu. Hastaların %72.0’sinde tam rezeksiyon (R0) elde edildi. Ortanca takip süresi 15.5 ay olup, 2 ila 85 ay arasında değişmektedir. Ortanca genel sağkalım 41 ay iken tahmini 18, 24 ve 36 aylık sağkalım oranları sırasıyla %60,1, %56,1 ve %50,5 idi. Yaş (>45 yıl; hazard oranı (HR): 3.199; %95 güven aralığı (CI): 0.899 - 11.380) ve asit varlığı (HR: 4.109, %95 CI: 1.436 - 11.757) sağkalımın bağımsız belirleyicileri olarak saptandı.
Sonuç: Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde, yaş ve asit varlığı prognozun ana belirleyicileri iken sitoredüktif cerrahinin sağkalım yararı gösterilememiştir.
Supporting Institution
Yok
Project Number
Yok
References
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- Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017 Jun;34(5):295-307. doi: 10.1007/s10585-017-9856-8.
- Zhang JJ, Cao DY, Yang JX, Shen K. Ovarian metastasis from nongynecologic primary sites: a retrospective analysis of 177 cases and 13-year experience. J Ovarian Res. 2020 Oct 27;13(1):128. doi: 10.1186/s13048-020-00714-8.
- Lionetti R, DE Luca M, Raffone A, Travaglino A, Coppellotti A, Peltrini R, Bracale U, D’Ambra M, Insabato L, Zullo F, D’Armiento M, Corcione F. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis. Minerva Obstet Gynecol. 2022;74(4):356-363. doi: 10.23736/S2724-606X.21.04797-7.
- Li X, Zhang W, Ding P, Guo R, Hong Z, Liu P, Wang Z, Yu Y, Fang C, Meng W, Zhang R, Qiu M. Clinical characteristics and prognostic factors of colorectal cancer patients with ovarian metastasis: a multicenter retrospective study. Int J Colorectal Dis. 2021;36(6):1201-1208. doi: 10.1007/s00384-021-03842-9.
- Skírnisdóttir I, Garmo H, Holmberg L. Non-genital tract metastases to the ovaries presented as ovarian tumors in Sweden 1990-2003: occurrence, origin and survival compared to ovarian cancer. Gynecol Oncol. 2007;105(1):166-71. doi: 10.1016/j.ygyno.2006.11.005.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660.
- Ayhan A, Guvenal T, Salman MC, Ozyuncu O, Sakinci M, Basaran M. The role of cytoreductive surgery in nongenital cancers metastatic to the ovaries. Gynecol Oncol. 2005;98(2):235-41. doi: 10.1016/j.ygyno.2005.05.028.
- Sal V, Demirkiran F, Topuz S, Kahramanoglu I, Yalcin I, Bese T, Sozen H, Tokgozoglu N, Salihoglu Y, Turan H, Iyibozkurt C, Kolomuc T, Sofiyeva N, Berkman S, Arvas M. Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites. Int J Gynecol Cancer. 2016;26(4):688-96. doi: 10.1097/IGC.0000000000000673.
- Kim WY, Kim TJ, Kim SE, Lee JW, Lee JH, Kim BG, Bae DS. The role of cytoreductive surgery for non-genital tract metastatic tumors to the ovaries. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):97-101. doi: 10.1016/j.ejogrb.2009.11.011.
- R C K, Thomas V, Thomas DS, Daniel S, Sebastian A, Thomas A, Chandy RG, Peedicayil A. Metastatic Tumors to the Ovary-a Surgeon’s Dilemma. Indian J Surg Oncol. 2021 Mar;12(1):152-157. doi: 10.1007/s13193-020-01267-4.
Clinicopathological characteristics and prognosis in ovarian metastatic tumors from non-gynecologic primary sites
Abstract
Aim: To investigate clinicopathological characteristics and prognosis in ovarian metastatic tumors from non-gynecologic primary sites.
Materials and methods: This study was a retrospective trial enrolling consecutive patients with ovarian metastasis from non-gynecologic primary sites, either diagnosed synchronous or metachronously, who underwent surgery at a single institution between January 2015 and December 2021. Clinicopathological characteristics of patients were extracted from patients’ charts and electronic database; and analyzed using Cox proportional hazard models.
Results: Of the 291 malignant ovarian tumors that underwent surgery, 33 (11.3%) had a diagnosis of ovarian metastasis from non-gynecologic primary sites. The most common primary tumor sites were colorectum (45.5%), stomach (15.2%), and breast (12.1%). Most of the patients exhibited elevated preoperative serum Ca-125 levels (71.4%); roughly half of the patients had syncronous ovarian metastases (48.5%); and approximately one third had peritoneal involvement (36.4%) and/or ascites (30.3%). A complete resection (R0) was achieved in 72.0% of the patients. The median follow-up time was 15.5 months, ranging from 2 to 85 months. The median overall survival (OS) was 41 months with estimated 18-, 24- and 36-month OS rates of 60.1%, 56.1% and 50.5%, respectively. Age (>45 years; hazard ratio (HR): 3.199; 95% confidence interval (CI): 0.899 – 11.380) and presence of ascites (HR: 4.109, 95% CI: 1.436 – 11.757) were independent predictors of OS.
Conclusion: In ovarian metastatic tumors from non-gynecologic primary sites, age and the presence of ascites are the main determinants of prognosis, while no survival benefit of cytoreductive surgery was demonstrated.
Keywords
Project Number
Yok
References
- Moore RG, Chung M, Granai CO, Gajewski W, Steinhoff MM. Incidence of metastasis to the ovaries from nongenital tract primary tumors. Gynecol Oncol. 2004;93(1):87-91. doi: 10.1016/j.ygyno.2003.12.039.
- Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017 Jun;34(5):295-307. doi: 10.1007/s10585-017-9856-8.
- Zhang JJ, Cao DY, Yang JX, Shen K. Ovarian metastasis from nongynecologic primary sites: a retrospective analysis of 177 cases and 13-year experience. J Ovarian Res. 2020 Oct 27;13(1):128. doi: 10.1186/s13048-020-00714-8.
- Lionetti R, DE Luca M, Raffone A, Travaglino A, Coppellotti A, Peltrini R, Bracale U, D’Ambra M, Insabato L, Zullo F, D’Armiento M, Corcione F. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis. Minerva Obstet Gynecol. 2022;74(4):356-363. doi: 10.23736/S2724-606X.21.04797-7.
- Li X, Zhang W, Ding P, Guo R, Hong Z, Liu P, Wang Z, Yu Y, Fang C, Meng W, Zhang R, Qiu M. Clinical characteristics and prognostic factors of colorectal cancer patients with ovarian metastasis: a multicenter retrospective study. Int J Colorectal Dis. 2021;36(6):1201-1208. doi: 10.1007/s00384-021-03842-9.
- Skírnisdóttir I, Garmo H, Holmberg L. Non-genital tract metastases to the ovaries presented as ovarian tumors in Sweden 1990-2003: occurrence, origin and survival compared to ovarian cancer. Gynecol Oncol. 2007;105(1):166-71. doi: 10.1016/j.ygyno.2006.11.005.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660.
- Ayhan A, Guvenal T, Salman MC, Ozyuncu O, Sakinci M, Basaran M. The role of cytoreductive surgery in nongenital cancers metastatic to the ovaries. Gynecol Oncol. 2005;98(2):235-41. doi: 10.1016/j.ygyno.2005.05.028.
- Sal V, Demirkiran F, Topuz S, Kahramanoglu I, Yalcin I, Bese T, Sozen H, Tokgozoglu N, Salihoglu Y, Turan H, Iyibozkurt C, Kolomuc T, Sofiyeva N, Berkman S, Arvas M. Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites. Int J Gynecol Cancer. 2016;26(4):688-96. doi: 10.1097/IGC.0000000000000673.
- Kim WY, Kim TJ, Kim SE, Lee JW, Lee JH, Kim BG, Bae DS. The role of cytoreductive surgery for non-genital tract metastatic tumors to the ovaries. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):97-101. doi: 10.1016/j.ejogrb.2009.11.011.
- R C K, Thomas V, Thomas DS, Daniel S, Sebastian A, Thomas A, Chandy RG, Peedicayil A. Metastatic Tumors to the Ovary-a Surgeon’s Dilemma. Indian J Surg Oncol. 2021 Mar;12(1):152-157. doi: 10.1007/s13193-020-01267-4.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Article |
| Authors | |
| Project Number | Yok |
| Publication Date | December 28, 2023 |
| Submission Date | April 13, 2023 |
| Published in Issue | Year 2023 Volume: 23 Issue: 3 |
