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Survival benefit of metastasectomy for Krukenberg tumors from gastric cancer

 Jae Ho Cheong  ;  Woo Jin Hyung  ;  Jian Chen  ;  Junuk Kim  ;  Seung Ho Choi  ;  Sung Hoon Noh 
 GYNECOLOGIC ONCOLOGY, Vol.94(2) : 477-482, 2004 
Journal Title
Issue Date
Adult ; Aged ; Female ; Humans ; Krukenberg Tumor/pathology ; Krukenberg Tumor/secondary* ; Krukenberg Tumor/surgery* ; Middle Aged ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/secondary* ; Ovarian Neoplasms/surgery* ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Treatment Outcome
OBJECTIVE: An optimal treatment strategy for ovarian metastases of gastric cancer has not been clearly established. The aim of this study was to examine the role of a metastasectomy in the management of metachronous Krukenberg tumors after curative surgery for gastric cancer.

METHODS: Among 1235 female patients who had undergone a curative gastric resection for stomach cancer between 1987 and 1998, 54 (4.4%) developed Krukenberg tumors as a first recurrence without evidence of a distant metastasis. Of these 54 patients, 33 underwent a metastasectomy while 21 did not. The survival duration between the two groups was analyzed and compared.

RESULTS: The clinicopathological features of Krukenberg tumors as well as those of the primary cancers in the two groups were similar. All 33 patients in the resection group underwent subsequent adjuvant chemotherapy, including the 7 who received intraperitoneal chemotherapy. The 21 patients in the non-resection group were managed by either systemic chemotherapy (n = 16) or supportive care (n = 5) alone. The median survival duration of all the patients was 9 months (95% confidence interval, 3-15 months). The median survival time in the resection group was 17 months (95% confidence interval, 10-24 months), which was significantly longer than that in the non-resection group, 3 months (95% confidence interval, 2-4 months) (P < 0.001).

CONCLUSION: Our results suggest that a metastasectomy was associated with an improved survival in patients with metachronous Krukenberg tumors from gastric cancer. These data offer a strong argument in favor of performing metastasectomy for Krukenberg tumors in the absence of an obvious distant metastasis.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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