Krukenberg tumours of colorectal origin : experience of a tertiary referral centre and review of the literature

Abstract

Aim: Krukenberg tumours are tumours of the gastrointestinal tract that metastasize to the ovary. The condition is uncommon and accounts for 5 per cent of ovarian tumours. It is our objective to describe the outcome of patients after resection of Krukenberg tumours of colorectal origin. Patients and Methods: The present study is a retrospective review of 20 patients with resection performed for Krukenberg tumours of colorectal origin from November 1996 to April 2010 at Queen Elizabeth Hospital, Hong Kong, China. Results: The most common colonic primary site was sigmoid colon (40 per cent). Thirteen patients (65 per cent) had T4 tumours. Ten patients (50 per cent) had synchronous tumours. Seven patients (35 per cent) had bilateral ovarian involvement. Nine patients (45 per cent) had elevated serum carcinoembryonic antigen levels. The median carbohydrate antigen 125 (was 57 U/mL (range: 12–850 U/mL). Seven patients (35 per cent) developed metastases after ovarian resection. The most common sites were intra-abdominal lymph nodes (15 per cent), bone (15 per cent) and liver (10 per cent). The overall 3- and 5-year survival rates after ovarian resection were 40 per cent and 25 per cent, respectively. Right colon cancer (30 per cent right colon vs 60 per cent left colon vs 10 per cent rectum, P = 0.021) and T4 staging of the colonic primary (30 per cent T3 vs 65 per cent T4, P = 0.033) were found to be poor prognostic factors for survival. Conclusion: Although recurrence after resection of Krukenberg tumours is common, bilateral salpingo-oophorectomy should still be considered. A more aggressive approach, such as debulking surgery or metastasectomy, is also recommended to improve the outcome of these patients.