ROMIC: studies on the Role of Ovarian Metastases In Colorectal cancer

This thesis evaluated the role of ovarian metastases in colorectal cancer patients. It particularly researched the rationale behind the need for increased awareness among physicians regarding the presence or development of ovarian malignancies in colorectal cancer patients. The relevance of this thesis is addressed by several findings. The first one is the fact that ovarian metastases seem to occur more frequently in younger/premenopausal colorectal cancer patients as compared to older patients. Secondly, in a highly selected patient population ovarian metastases are not as harmful as previously expected. Furthermore, the ovaries are generally considered unresponsive to systemic therapy, which is unfortunately still poorly understood. Cytoreductive surgery (operative removal of tumors) followed by hyperthermic intraperitoneal chemotherapy (HIPEC, warm chemotherapy circulating in the peritoneum) showed better overall survival in colorectal cancer patients with ovarian metastases compared with surgery alone. Another finding is that there is a higher incidence of (primary) ovarian cancer in colorectal cancer patients compared to the general population. Lastly, oncologic outcomes may improve following a prophylactic salpingo-oophorectomy in colorectal cancer patients.