Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer

Jae Ho Cheong, WooJin Hyung, Jian Chen, Junuk Kim, Seung Ho Choi, Sung Hoon Noh

Research output: Contribution to journalArticle

30 Citations (Scopus)

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 (RO) 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 RO 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 RO 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 RO 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.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalJournal of Surgical Oncology
Volume87
Issue number1
DOIs
Publication statusPublished - 2004 Jul 15

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Krukenberg Tumor
Stomach Neoplasms
Confidence Intervals
Pelvis
Disease-Free Survival
Metastasectomy
Databases
Survival
Residual Neoplasm
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Cheong, Jae Ho ; Hyung, WooJin ; Chen, Jian ; Kim, Junuk ; Choi, Seung Ho ; Noh, Sung Hoon. / Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer. In: Journal of Surgical Oncology. 2004 ; Vol. 87, No. 1. pp. 39-45.
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title = "Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer",
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 (RO) 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 RO 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 RO 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 RO 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.",
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Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer. / Cheong, Jae Ho; Hyung, WooJin; Chen, Jian; Kim, Junuk; Choi, Seung Ho; Noh, Sung Hoon.

In: Journal of Surgical Oncology, Vol. 87, No. 1, 15.07.2004, p. 39-45.

Research output: Contribution to journalArticle

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AU - Cheong, Jae Ho

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