The role of prophylactic oophorectomy in women undergoing surgery for colorectal cancer

Authors


Mr B. J. Moran, Consultant Surgeon, Colorectal Research Unit, North Hampshire Hospital, Basingstoke, RG24 9NA, UK.
E-mail: Brendan.Moran@nhht.nhs.uk

Abstract

Background  Current gynaecological practice is to remove surgically accessible ovaries with prior consent in post menopausal women to eradicate the risk of subsequent development of ovarian cancer. However in colorectal surgery opinion is divided, although evidence suggests that ovarian metastases from colorectal adenocarcinoma occur in 3–4% of cases.

Methods  The review is based on published literature of the role of prophylactic oophrectomy in women undergoing surgery for colorectal cancer, obtained from Medline/PubMed and other online databases using the terms ‘prophylactic oophorectomy’ and ‘colon cancer’. Additional references were sourced by manually searching bibliographies of articles located.

Results and conclusion  There is a paucity of published information and published reports have conflicting conclusions. A preliminary report of a randomised prospective trial suggests the probability of increased recurrence free survival in the oophorectomy group. It would seem appropriate to consider the necessity and possible benefits of oophorectomy in women prior to surgery for colorectal cancer. This would seem particularly relevant in distal sigmoid or upper rectal cancers when the ovaries or uterus may be directly invaded and curative surgery would involve en bloc resection. Post menopausal women with a family history of ovarian cancer should be advised to have oophorectomy.

Ancillary