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Comparison of surgery plus chemotherapy and palliative chemotherapy alone for advanced gastric cancer with krukenberg tumor

 Jang Ho Cho  ;  Jae Yun Lim  ;  Jae Yong Cho  ;  Seung Ho Choi  ;  Jong Won Kim  ;  Sung Min Choi  ;  Ah Ran Choi 
 CANCER RESEARCH AND TREATMENT, Vol.47(4) : 697-705, 2015 
Journal Title
Issue Date
Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Krukenberg Tumor/drug therapy ; Krukenberg Tumor/secondary* ; Krukenberg Tumor/surgery ; Krukenberg Tumor/therapy* ; Male ; Metastasectomy* ; Middle Aged ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/secondary* ; Ovarian Neoplasms/surgery ; Ovarian Neoplasms/therapy* ; Palliative Care* ; Prognosis ; Stomach Neoplasms/pathology* ; Treatment Outcome
Krukenberg tumor ; Metastasectomy ; Prognosis ; Stomach neopla는
PURPOSE: This study was conducted to validate the survival benefit of metastasectomy plus chemotherapy over chemotherapy alone for treatment of Krukenberg tumors from gastric cancer and to identify prognostic factors for survival. MATERIALS AND METHODS: Clinical data from 216 patients with Krukenberg tumors from gastric cancer were collected. Patients were divided into two arms according to treatment modality: arm A, metastasectomy plus chemotherapy and arm B, chemotherapy alone. RESULTS: Overall survival (OS) was significantly increased in arm A relative to arm B for patients initially diagnosed with stage IV gastric cancer (18.0 months vs. 8.0 months; p < 0.001) and those with recurrent Krukenberg tumors (19.0 months vs. 9.0 months; p=0.002), respectively. Metastasectomy (hazard ratio [HR], 0.458; 95% confidence interval [CI], 0.287 to 0.732; p=0.001), signet-ring cell pathology (HR, 1.583; 95% CI, 1.057 to 2.371; p=0.026), and peritoneal carcinomatosis (HR, 3.081; 95% CI, 1.610 to 5.895; p=0.001) were significant prognostic factors for survival. CONCLUSION: Metastasectomy plus chemotherapy offers superior OS when compared to palliative chemotherapy alone in gastric cancer with Krukenberg tumor. Prolonged survival applies to all patients, regardless of gastric cancer stage. Metastasectomy, signet-ring cell pathology, and peritoneal carcinomatosis were prognostic factors for survival. Future prospective randomized trials are needed to confirm the optimal treatment strategy for Krukenberg tumors from gastric cancer.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Cho, Jae Yong(조재용) ORCID logo https://orcid.org/0000-0002-0926-1819
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
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