Prophylactic oophorectomy in surgery for large-bowel cancer

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Abstract
From 1968-1975, 201 women had prophylactic oophorectomy at the time of definitive large-bowel resection; in 134 patients oophorectomy was not performed. Oophorectomy was performed more commonly in women with cancer of the rectum and rectosigmoid. More patients undergoing oophorectomy had Dukes'' C primary carcinoma. Four patients undergoing synchronous oophorectomy (2.0%) had ovarian involvement or metastases from large-bowel cancer. Three patients (2.2%) developed subsequent ovarian disease (2 cases of ovarian carcinoma and 1 case of ovarian metastases from primary breast cancer). No late ovarian recurrences of large-bowel cancer were seen. No patient with ovarian involvement or metastases from large-bowel cancer survived 5 yr; nor was the overall survival of the group of women undergoing oophorectomy materially affected. Stage and site significantly influenced survival; oophorectomy, menopausal status, preoperative irradiation, tumor size and degree of differentiation had no influence. The prevention of primary ovarian cancer in postmenopausal women is considered to be the main benefit of bilateral prophylactic oophorectomy. Selective recommendations for oophorectomy under other circumstances are discussed.