Synchronous Ovarian Metastasis in Apparently Normal Ovaries During Surgery for Gastric and Colorectal Carcinoma: The Role of Routine Ovarian Biopsy

Abstract

PurposeWe investigate the presence of ovarian micrometastasis during surgery for gastric and colorectal carcinoma, and seek to identify risk factors for the development of synchronous ovarian metastasis. Patients and MethodsA cross-sectional study was performed from March 1, 2007 to the end of March, 2009. It included 24 patients with gastric and colorectal carcinoma who underwent surgical treatment. Cases with apparently normal ovaries were subjected to bilateral ovarian biopsies and examined immediately by frozen section technique, while cases with gross ovarian lesions were subjected to bilateral salpingo-oophorectomy or panhysterectomy. ResultsOvarian metastases are confirmed in our study in 7 cases (29.2%). Two of these cases (8.3%) were associated with normal ovaries while, in the other 5 cases (20.8%), ovarian metastases were associated with unilateral or bilateral gross ovarian pathology. The 7 cases were exposed during the same procedure to bilateral salpingo-oophorectomy (5 cases) or panhysterectomy (2 cases). For patients who underwent ovarian biopsy, there were no reported intraoperative or early postoperative complications. ConclusionBilateral ovarian biopsies can be performed during surgery for gastric and colorectal carcinomas for cases with apparently normal ovaries as a novel technique for the detection of ovarian micrometastasis. Ovarian metastasis was associated with younger age of patients, advanced disease stage, and anatomical site of the primary tumor, but was not significantly related to grade of differentiation of the primary tumor.