Ovarian Carcinoma Metastases to Gastrointestinal Tract Appear to Spread like Colon Carcinoma: Implications for Surgical Resection

• Published in: Gynecologic oncology 1995-11, Vol.59 (2), p.200-206
• Main Authors: O'HANLAN, KATHERINE A., KARGAS, STEPHEN, SCHREIBER, MATTHEW, BURRS, DEMETRA, MALLIPEDDI, PADMA, LONGACRE, TERI, HENDRICKSON, MICHAEL
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Intestinal Neoplasms - pathology; Intestinal Neoplasms - secondary; Intestinal Neoplasms - surgery; Medical sciences; Neoplasm Invasiveness; Ovarian Neoplasms - pathology; Retrospective Studies; Tumors
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.1995.0008

Objective: To profile the incidence of mesenteric lymph node metastases in patients with ovarian carcinoma and metastases to the gastrointestinal tract in order to determine the optimal technique for surgical debulking. Methods: The slides and charts of all patients with ovarian carcinoma who had undergone bowel resection were retrospectively reviewed and follow-up information was obtained. Results: Of 100 separate bowel resections 44% had penetration of metastases to the muscularis, 18% had invasion through the submucosa, 4% had mucosal perforation, and two patients had clinical perforation. Fifty-five percent of all resections demonstrated lymph–vascular space invasion (LVSI). In the 33 specimens which included pathologic analysis of mesenteric lymph nodes, 79% had positive LVSI, which correlated with the presence of mesenteric lymph node metastases (P= 0.05) but not histologic grade (P= 0.20). When surgery was performed for secondary debulking, the frequency of mesenteric node metastasis was higher (P= 0.15). There was a trend for patients with positive mesenteric nodes to fail sooner (median survival, 20 months vs 32 months). Conclusions: Because ovarian carcinoma metastases to the gastrointestinal tract are frequently associated with metastases to mesenteric lymph nodes, gynecologic oncology surgeons may wish to consider resection of the mesentery in a wedge fashion similar to current standards of resection for primary bowel carcinoma in cases in which a bowel resection is being performed with the intent to debulk to zero visible residual disease.