Survival benefit of metastasectomy for Krukenberg tumors from gastric cancer.
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).


CONCLUSIONS
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.
Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Ku, Seoul 120-752, South Korea.
Jae Ho
JH
Cheong
Woo Jin
WJ
Hyung
Jian
J
Chen
Junuk
J
Kim
Seung Ho
SH
Choi
Sung Hoon
SH
Noh
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007725:Krukenberg Tumor / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome