J Cancer 2018; 9(22):4197-4203. doi:10.7150/jca.25593

Research Paper

Management Of Synchronous Krukenberg Tumors From Gastric Cancer: a Single-center Experience

Dingding Yan1*, Yian Du2*, Gaiguo Dai2, Ling Huang2, Qi Xu3, Pengfei Yu2✉*

1. Department of Gynecologic oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China;
2. Department of Abdominal Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China;
3. Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Yan D, Du Y, Dai G, Huang L, Xu Q, Yu P. Management Of Synchronous Krukenberg Tumors From Gastric Cancer: a Single-center Experience. J Cancer 2018; 9(22):4197-4203. doi:10.7150/jca.25593. Available from http://www.jcancer.org/v09p4197.htm

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Background: Whether metastasectomy improves prognosis of gastric cancer patients with ovarian metastases (Krukenberg tumors) is not clear. In this study, we examined the survival benefit of metastasectomy combined with chemotherapy for treatment of synchronous Krukenberg tumors from gastric cancer and identified the prognostic factors.

Methods: The subjects of this study were patients diagnosed as synchronous Krukenberg tumors of gastric origin in the period between December 2004 and December 2015. Patients were classified in accordance with treatment modality: metastasectomy group (metastasectomy combined with chemotherapy) and non-metastasectomy group (chemotherapy alone). Clinicopathological characteristics together with treatment records were investigated in detail and their relationship with survival outcomes was examined.

Results: Out of a total of 103 patients, 54 (52.4%) underwent metastasectomy of Krukenberg tumors while 49 (47.6%) patients had chemotherapy alone. Overall survival (OS) in the metastasectomy group was significantly longer than that in the non-metastasectomy group (18.9 months vs. 12.4 months, respectively; P<0.001). Metastasectomy (hazard ratio [HR] 0.486; 95% confidence interval [CI] 0.323-0.729; P<0.001), signet ring cells (HR 1.938; 95% CI 1.182-3.175; P=0.009), peritoneal carcinomatosis (HR 1.934; 95% CI 1.230-3.049; P=0.004), expression of estrogen receptor-β (ER-β) (HR 0.404; 95% CI 0.251-0.648; P<0.001), and progesterone receptor (PR) (HR 0.496; 95% CI 0.301-0.817; P<0.001) were independent predictors of OS.

Conclusion: Metastasectomy combined with chemotherapy showed an association with survival benefit in patients with synchronous Krukenberg tumors from gastric cancer. Metastasectomy, expression of ER-β and PR, peritoneal carcinomatosis, and signet ring cells were independent predictors of survival. Further prospective studies are warranted.

Keywords: Krukenberg tumors, gastric neoplasm, metastasectomy, chemotherapy, prognosis