title: Clinical analysis of Krukenberg tumours in patients with colorectal cancer-a review of 57 cases.
abstract: BACKGROUND
  A Krukenberg tumour (KT) is defined as an ovarian metastasis from a gastrointestinal adenocarcinoma and suggests a terminal condition. This study aimed to identify the prognostic factors affecting the survival of patients with KTs of colorectal origin who receive cytoreductive surgery.
  
  
  METHODS
  Medical records of patients who had received cytoreductive surgery and had been pathologically diagnosed with KT of colorectal origin in two centres were reviewed. Information about the patients' clinicopathological features and follow-up visit were collected. Factors influencing patient survival were analysed.
  
  
  RESULTS
  Fifty-seven patients were included in this study. The median survival time was 35 months. Five-year overall survival was 25%. Patients who had recurrence 2 years after resection of the primary tumour, achieved complete cytoreduction, had metastases confined to the pelvis, had no lymph node involvement, and received systemic chemotherapy had a significantly longer median survival than those who had recurrence at the same time as resection of the primary tumour (P = 0.027), received incomplete cytoreduction (P < 0.001), had metastases beyond the pelvis (P < 0.001), had lymph node involvement (P = 0.011), and did not receive systemic chemotherapy (P = 0.006) on log-rank test. Less extensive metastatic disease, achievement of complete cytoreduction, and use of systemic chemotherapy were significantly associated with improved prognosis on multivariate analysis.
  
  
  CONCLUSIONS
  Cytoreductive surgery may confer survival benefits in patients with KTs of colorectal origin who attain complete cytoreduction and whose metastases are confined to the pelvis and when combined with active systemic chemotherapy.
authors.affiliation: Department of Surgical Oncology, Beijing Shijitan Hospital and Cancer Centre of Capital Medical University, Beijing, China.
authors.forename: K Y
authors.initials: KY
authors.lastname: Xu
authors.affiliation: Department of Surgical Oncology, Beijing Shijitan Hospital and Cancer Centre of Capital Medical University, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Surgical Oncology, Beijing Shijitan Hospital and Cancer Centre of Capital Medical University, Beijing, China.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Lian
authors.affiliation: Department of Surgical Oncology, Beijing Shijitan Hospital and Cancer Centre of Capital Medical University, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Colorectal Surgery, Beijing Cancer Hospital, No. 52, Road Fu Shi, District Haidian, Beijing, China.
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Colorectal Surgery, Beijing Cancer Hospital, No. 52, Road Fu Shi, District Haidian, Beijing, China. guj@educationcmac.com.
authors.forename: J
authors.initials: J
authors.lastname: Gu
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007725:Krukenberg Tumor / Q000556:secondary* / Q000628:therapy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: Cytoreductive surgery; Krukenberg tumour; Prognostic factors