Adnexal masses in patients with colorectal cancer

J Gynecol Obstet Hum Reprod. 2021 May;50(5):101898. doi: 10.1016/j.jogoh.2020.101898. Epub 2020 Aug 19.

Abstract

Objective: To evaluate the clinicopathological features and outcomes of patients undergone surgery for benign and metastatic adnexal masses during the surveillance of colorectal cancer (CRC).

Methods: A single institute retrospective study involving 90 patients diagnosed with CRC that undergone surgery at Hacettepe University Hospital between 2000-2018. Clinicopathological and survival data was obtained from hospital records.

Results: Elevated blood levels of CEA (HR, 1.23; 95 % CI: 1.03-1.24; p = 0.01), adnexal masses larger than 5 cm (HR, 3.296; 95 % CI: 1.527-7.076; p = 0.002), bilaterality of adnexal mass (HR, 2.200; 95 % CI: 2.464-11.969; p = 0.001) and high PCI score (HR, 0.150; 95 % CI: 0.044-0.479; p = 0.01) were found to be significantly associated with ovarian metastasis. There was a significant difference in overall survival (OS), with respect to complete and incomplete resection in adnexal surgery of ovarian metastasis (46.6 vs. 29.6 months; p = 0.004). The median survival time was 32.8 months for patients with ≤ 24 months interval time to adnexal metastasis surgery, and 48.5 months for patients with >24 months interval time to adnexal metastasis surgery (p = 0.001).

Conclusion: This study showed that numerous clinicopathological variables such as bilaterality and size of adnexal mass, serum blood levels of CEA and PCI score may have a significant impact on the prediction and management of ovarian masses diagnosed during CRC surveillance. Complete resection and interval time to adnexal surgery is significantly associated with OS.

Keywords: Adnexal mass; Colorectal cancer; Ovarian metastasis.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Adnexal Diseases / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoembryonic Antigen / blood
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / pathology*
  • Female
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / secondary*
  • Ovarian Neoplasms / surgery
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / secondary
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / pathology*
  • Retrospective Studies
  • Young Adult

Substances

  • Carcinoembryonic Antigen