Histopathological assessment to detect colorectal ovarian micrometastasis following prophylactic salpingo-oophorectomyin postmenopausal patients

Sep 29, 2026

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Study evaluates the prevalence of colorectal (micro)metastases in tubo-ovarian tissue after prophylactic salpingo-oophorectomy in postmenopausal CRC patients. Retrospective analysis of adnexa from patients undergoing primary tumor resection with concurrent PSO used routine histopathology and additional immunohistochemical staining for CK20 and CDx2 across five tissue levels. Among 100 consecutive patients, ovarian malignancies were found in 4%, and immunohistochemistry did not reveal additional CRC (micro)metastases.

LanguageEnglish

CategoryHealthcare

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Pages6

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Abstract

Introduction

Material and methods

Results

Discussion

Keywords

International Journal of Colorectal Disease (2026) 41:11 [https://doi.org/10.1007/s00384-025-05042-1](https://doi.org/10.1007/s00384-025-05042-1) Histopathological assessment to detect colorectal ovarian micrometastasis following prophylactic salpingo-oophorectomyin postmenopausal patients Jasper F. J. A. van Zon1 · Margot H. M. Heijmans1 · Steven L. Bosch2 · Johanne Bloemen3 · Wouter K. G. Leclercq1 · Rudi M. H. Roumen1 Received: 17 June 2024 / Accepted: 18 November 2025 © The Author(s) 2026 Abstract Introduction Colorectal cancer (CRC) is one of the most prevalent malignancies and often leads to metastatic disease. Ovarian metastasis occurs in approximately 4% of all female CRC patients. Metastatic disease recurrence after intentional curative resection of primary colorectal tumour could be explained by the presence of micrometastases. The present study aims to investigate the prevalence of CRC (micro)metastases in tubo-ovarian tissue following prophylactic salpingo-oophorectomy (PSO) in postmenopausal patients. Material and methods Analyses of both adnexa of postmenopausal CRC patients who underwent primary tumour resection and concurrent PSO were conducted retrospectively. Tissue blocks with formalin fixed paraffin embedded ovarian tissue were sectioned at five levels, and both routine histopathological and additional immunohistochemical staining for CK20 and CDx2 were performed. The primary outcome measure was the incidence of CRC micrometastases (%) . Results Ovaries of 100 consecutive CRC patients who underwent surgery at two Dutch teaching hospitals were analysed (age 72.7 ± 7.6 years, pT0–2 (43%), and pN0 (65%)). Overall, ovarian malignancies were found in 4% of patients. Immunohistochemical analysis revealed no additional CRC (micro)metastases. Discussion Additional immunohistochemical assessment did not reveal CRC ovarian (micro)metastases in an unselected patient cohort. The absence of micrometastases could be attributed to patient selection criteria and/or sampling error. Future research should focus on identifying a subgroup at high risk of developing ovarian metastasis and on the improvement of diagnostic and therapeutic strategies. Keywords Colorectal cancer · Ovarian malignancy · Micrometastasis · Immunohistochemical analysis · Prophylacticsalpingo-oophorectomy Introduction Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide [1]. In women, it is second only to breast cancer, representing nearly 10% of all female cancer cases * Jasper F. J. A. van Zon [romic.resurge@mmc.nl](romic.resurge@mmc.nl) 1 Department of Pathology, Eurofins-PAMM, Eindhoven, The Netherlands 2 Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands 3 Department of Surgery, Catharina Cancer Institute, Eindhoven, The Netherlands [1, 2] . Ovarian metastasis occurs in approximately 4% of female CRC patients [3], although reported incidence rates range from 0.8% to 8%[4–6] . Overall, patients with colorectal ovarian metastases (CROM) have a very poor prognosis, with a 5-year survival rate of 12–27%[7] and a median survival of 25 months [8] . Notably, the presence of ovarian metastases is often indicative of advanced disease. It is well established that ovarian metastases, as well as primary ovarian carcinoma, frequently progress asymptomatically [9] . Furthermore, colorectal ovarian metastases may function as“sanctuary sites”, exhibiting reduced sensitivity to chemotherapy [10–16] . Current treatment options have proven tobe ineffective. Given the poor prognosis and regular occurrence of ovarian metastases in female CRC patients, prophylactic salpingo-oophorectomy (PSO) could be considered for these women. From this perspective, PSO has been offered to postmenopausal CRC patients in several Dutch hospitals since 2020. The occurrence of ovarian metachronous metastasis can be explained by a phenomenon attributed to the prior dissemination of a small number of tumour ce

FAQs

What is the primary aim of the study?

To investigate the prevalence of colorectal (micro)metastases in tubo-ovarian tissue after prophylactic salpingo-oophorectomy in postmenopausal CRC patients.

How were micrometastases evaluated in the research?

Both routine histopathological assessment and additional immunohistochemical staining for CK20 and CDx2 were performed on formalin-fixed, paraffin-embedded ovarian tissue sections at five levels.

What were the main findings regarding colorectal ovarian micrometastases?

Overall ovarian malignancies were identified in 4% of patients, and immunohistochemical analysis revealed no additional CRC (micro)metastases.

Sep 29, 2026

Uploaded by Aria