title: Surgical treatment for patients with different origins of Krukenberg tumors: outcomes and prognostic factors.
abstract: OBJECTIVE
  We sought to investigate survival impacts of metastasectomy in women with Krukenberg tumors of the ovary and survival benefits in different origins (gastric cancer, colorectal cancer, or others).
  
  
  METHODS
  All patients diagnosed with Krukenberg tumors of the ovary who underwent surgical treatment at a single institution between 1997 and 2003 were retrospectively evaluated. Survival analyses and comparisons were performed using Kaplan-Meier method and log-rank test.
  
  
  RESULTS
  A total of 54 patients with Krukenberg tumors of the ovary were identified. The estimated 5-year survival was 12.1%. The median survival in patients with microscopic residual disease after metastasectomy was 29.6 months, compared to 10 months in those with visible residual disease (P<0.01). The median survival among patients with Krukenberg tumors of gastric origin, colon and rectum origin, and other origins were 13 months, 29.6 months, and 48.2 months, respectively (P=0.03). There was a significant difference in survival between patients with metastatic disease confined to the ovaries and those with extensive metastases, with an estimated median survival of 30.7 months and 10 months, respectively (P=0.02). Multivariate analysis suggested that the origin of ovarian metastatic carcinoma (P<0.01), residual disease after metastasectomy (P<0.01), and KPS (Karnofsky performance status) (P=0.03) were independent prognostic factors of survival.
  
  
  CONCLUSIONS
  Patients with Krukenberg tumors from colorectal cancer experience a better prognosis than those from gastric cancer and benefit more from metastasectomy. And metastasectomy significantly lengthens overall survival in patients with primary colorectal or breast cancer, higher KPS score, and those with optimal metastasectomy.
authors.affiliation: Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Cancer Hospital, Shanghai, China.
authors.forename: R
authors.initials: R
authors.lastname: Jiang
authors.forename: J
authors.initials: J
authors.lastname: Tang
authors.forename: X
authors.initials: X
authors.lastname: Cheng
authors.forename: R Y
authors.initials: RY
authors.lastname: Zang
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007725:Krukenberg Tumor / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome