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Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer

Authors
 Jae Ho Cheong  ;  Woo Jin Hyung  ;  Jian Chen  ;  Junuk Kim  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.87(1) : 39-45, 2004-07 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2004-07
MeSH
Adult ; Aged ; Disease-Free Survival ; Female ; Humans ; Krukenberg Tumor / etiology ; Krukenberg Tumor / mortality ; Krukenberg Tumor / surgery* ; Middle Aged ; Multivariate Analysis ; Neoplasms, Second Primary / etiology ; Neoplasms, Second Primary / surgery* ; Ovarian Neoplasms / etiology ; Ovarian Neoplasms / mortality ; Ovarian Neoplasms / surgery* ; Prospective Studies ; Stomach Neoplasms* / pathology ; Stomach Neoplasms* / surgery ; Survival Rate ; Treatment Outcome
Abstract
Background and objectives: The question of whether resection should be performed in Krukenberg tumors from gastric cancer has yet to be adequately examined. Despite some reports on the surgical treatment of Krukenberg tumors, the outcomes after resection are not well characterized. Patients and methods: Using a gastric cancer database, a total of 34 patients who underwent a resection of metastatic ovarian tumors after curative surgery for gastric cancer were identified. A prospective database of these patients was reviewed for the presentation, clinical features, and outcomes after resection. Results: The median age of 34 patients was 44 years (range, 24-66). The majority of patients was in the premenopausal state and had bilateral ovarian involvement. The most common presenting symptom was an abdominal mass (35.3%). Tumor size ranged from 3.5 to 20 cm with 61.8% measuring larger than 10 cm. In 17 patients who had metastatic disease confined to the pelvis, a complete gross resection (R0) was achieved. In the other 17 with the disease beyond the pelvis gross residual tumors remained after the resection (R1). The median survival of all patients was 11 months (95% confidence interval [CI] 8-14), and that of the patients rendered R0 was 18 months (95% CI, 14-22), in comparison with 9 months (95% CI, 3-15) for those with R1 resection (P = 0.0001; log-rank test). The median progression free survival was also significantly longer for the patients with R0 resection than those with R1 resection (8 months, 95% CI, 5-11 vs. 5 months, 95% CI, 4-6, P = 0.0103). Multivariate analysis identified R0 resection as the only significant factor predictive of survival. Conclusions: In the management of Krukenberg tumors after gastric cancer, a metastasectomy may significantly improve the overall and progression free survival if it could render a complete gross resection. To define the patient group that benefits most from resection, the extent of disease and resectability must be carefully evaluated before surgery.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1002/jso.20072
DOI
10.1002/jso.20072
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178880
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