The ovary is a potential site of recurrence in patients with colorectal cancer after resection of the primary tumor. The prophylactic bilateral oophorectomy at the time of primary resection for colorectal cancer is still debated, since this procedure has not been proven to affect survival. However, surgery for symptomatic ovarian metastases developing at a later time may be avoided, and the risk of primary ovarian cancer, particularly in patients with mutations in BRCA1 and BRCA2, is eliminated. The stromal cell–cancer cell interaction, increased angiogenesis, abundance of EGF and HGF, and prostaglandins may make the ovarian microenvironment a preferred tissue of implantation of colorectal cancer cells and provide the biologic basis of aggressive surgery to remove a potential site of tumor recurrence.
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