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

Gwon Sik Kim; Kap Choong Kim; Beom Su Kim; Tae Hwan Kim; Heong Hwan Yook; Sung Tae Oh; Byung Sik Kim

doi:10.5230/jgc.2010.10.3.111

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Kim, Kim, Kim, Kim, Yook, Oh, and Kim: Utility of Surgical Resection in the Management of Metachronous Krukenberg's Tumors of Gastric Origin

Original Article

Journal of Gastric Cancer

Journal of Gastric Cancer 2010; 10(3): 111-117.

Published online: 30 September 2010

DOI: https://doi.org/10.5230/jgc.2010.10.3.111

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

Gwon Sik Kim, Kap Choong Kim, Beom Su Kim, Tae Hwan Kim, Heong Hwan Yook, Sung Tae Oh, Byung Sik Kim

Department of Surgery, Division of Gastric Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.

Correspondence to: Byung Sik Kim. Division of Gastric Surgery, Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, 388-1, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3491, Fax: +82-2-474-9027, bskim@amc.seoul.kr

Received 8 June 2010 Accepted 1 September 2010

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.

Keywords: Gastric cancer, Krukenberg's tumor, Ovarian metastasis

Figures and Tables

Table 1

Clinicopathological characteristics of primary gastric cancer (N=90)

WD = well differentiated; MD = moderately differentiated; PD = poorly differentiated; SRC = signet ringcell; UD = undifferentiated.

Table 2

Univariate analysis of prognostic factors for primary gastric cancer

Table 3

Multivariate analysis of prognostic factors for primary gastric cancer

Table 4

A comparative analysis of overall survival time after primary gastric surgery between operative group and non-operative group in patients with metachronous Krukenberg's tumor

Table 5

Analysis for prognostic factors of primary gastric cancer and recurrence time in patients with metachronous Krukenberg's tumor (n=53)

Table 6

Univariate analysis of prognostic factors for survival after the development of metachronous Krukenberg's tumor

Table 7

Multivariate analysis of prognostic factors for survival after the development of metachronous Krukenberg's tumor

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