J Gastric Cancer.  2010 Sep;10(3):111-117.

Utility of Surgical Resection in the Management of Metachronous Krukenberg's Tumors of Gastric Origin

• Kim GS
• Kim KC
• Kim BS
• Kim TH
• Yook HH
• Oh ST
• Kim BS

Abstract

PURPOSE
The aim of this study was to determine the prognostic factors and the significance of metastatectomy for Krukenberg's tumors of gastric origin.
MATERIALS AND METHODS
Among the patient who underwent gastric surgery from 1992 through 2005, 90 female patients with Krukenberg's tumors of gastric origin were identified. We retrospectively reviewed the clinicopathologic characteristics, prognostic factors, and treatments for primary gastric cancer. We also investigated the prognostic risk factors for the onset of metachronous Krukenberg's tumors and the survival time of patients who underwent an operation for metachronous Krukenberg's tumors.
RESULTS
The presence of a synchronous Krukenberg's tumor (mean survival time=17.6 months, P<0.01), peritoneal seeding (14.5 months, P<0.01), and non-curative resection (15.1 months, P<0.01), were statistically significant prognostic factors for survival time in female patients with gastric cancer. The stage of primary gastric cancer (P=0.049) and lymph node metastasis (P=0.011) were statistically significant risk factors for recurrence time of a metachronous Krukenberg's tumor. In the metachronous Krukenberg's tumor group (n=53), the mean survival time of the metastatectomy group (n=46, 43.2 months, P=0.012) was longer than that in the chemotherapy or conservative treatment groups (n=7 and 24 months, respectively). Metastatectomy, presense or abscence of residual tumor and extent of residual tumor were significant prognostic factors for survival time in female patients with metachronous Krukenberg's tumor of gastric origin.
CONCLUSIONS
A close observation and evaluation with ultrasound or computed tomography is necessary in female patients with advanced gastric cancer to detect a metachronous Krukenberg's tumor as soon as possible. The surgeon must operate more aggressively in patients with metachronous Krukenberg's tumors.

Keyword

Gastric cancer; Krukenberg's tumor; Ovarian metastasis

MeSH Terms

Female
Humans
Krukenberg Tumor
Lymph Nodes
Neoplasm Metastasis
Neoplasm, Residual
Recurrence
Retrospective Studies
Risk Factors
Seeds
Stomach Neoplasms
Survival Rate

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