Leinkühler, M. (Maleen) (2015) What is the mechanism of metastatic spread to the ovaries in colon cancer? thesis, Medicine.
Full text available on request.Abstract
Colon cancer frequently metastasizes to the ovaries. Up to now there is discussion whether tumour cells spread to the ovaries by a haematogenous, peritoneal or lymphatogenous route. The route through which tumour cells metastasize has severe implications for the treatment of the patients. The standard treatment now is cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC), but this would only be an effective treatment if ovarian metastases result from peritoneal spread. This study aims to get indications about the mechanism of spread. Methods The medical records of patients treated for ovarian metastases from colorectal cancer between 2000 and 2014 were analysed. To find possible correlations between variables the Pearson’s chi square test or the Fisher’s Exact test was used (making use of IBM SPSS 22). Results A total of 179 medical records were reviewed, 56 were included for analysis plus 7 pathology reports from patients whose medical record was not available. Patient and tumour characteristics can be found in table 1. Median age was 59 years (N = 56). Most primary tumours were found in the appendix (N = 19). Sixteen patients had a T3 tumour status and 20 patients had a T4 status. There were significantly more patients with peritoneal carcinomatosis than without it (p < 0.001). Most patients had synchronous metastases intra-abdominal (N = 19), in the liver (N = 6) or metastases in abdominal and distant organs (N = 13). Chi square testing found no significant correlation between the location of the primary tumour and the laterality of the ovarian metastases (χ² = 4.330, p = 0.115). Binominal testing revealed significantly more metastases deep in the ovaries than on the surface (p < 0.001), but no significant difference between the number of intact and infiltrated capsules (p = 0.366). Conclusion The high number of primary tumours in the appendix and the frequent occurrence of peritoneal carcinomatosis and intra-abdominal metastases associated with ovarian metastases suggest peritoneal spreading of ovarian metastases. The treatment of these patients with HIPEC therefore seems the best option.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervised by and Leeuwen dr. B.L. van and Hemmer, P.H.J. and Department of oncological surgery at the University Medical |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1210 |
Actions (login required)
 |
View Item |