Abstract
BackgroundGastric cancer patient with ovarian metastasis is common in clinical practice, but it is still uncertain whether surgical resection of ovarian metastasis could improve the outcome. This study aimed to explore the survival benefit of metastasectomy plus chemotherapy over chemotherapy alone in the treatment of Krukenberg tumors arising from gastric cancer and to identify prognostic factors.ResultsA total of 152 patients were identified, including 93 patients with synchronous ovarian metastasis and 59 patients with metachronous ovarian metastasis. Overall survival (OS) was significantly better in metastasectomy group relative to the non-metastasectomy group for patients with synchronous ovarian metastasis (19.0 months vs. 11.8 months; P < 0.001) and those with metachronous ovarian metastasis (24.6 months vs. 14.3 months; P = 0.02), respectively. Metastasectomy (hazard ration [HR] 0.486; 95% confidence interval [CI] 0.323–0.729; P < 0.001), peritoneal carcinomatosis (HR 1.934; 95% CI 1.230–3.049; P = 0.004), and expression status of ER-β (HR 0.404; 95% CI 0.251–0.648; P < 0.001) and PR (HR 0.496; 95% CI 0.301–0.817; P < 0.001) were independent predictors of OS.MethodsAll patients who were diagnosed with gastric cancer and ovarian metastases between January 2005 and December 2014 were included in the current study. Patients were subdivided according to treatment modality: the metastasectomy group (metastasectomy plus chemotherapy) and the non-metastasectomy group (chemotherapy alone). The clinicopathological features and the treatment records were reviewed in detail and their association with survival were analyzed.ConclusionMetastasectomy plus chemotherapy was associated with survival benefits in patients with Krukenberg tumors from gastric cancer. Metastasectomy, peritoneal carcinomatosis, and expression status of ER-β and PR were independent prognostic factors for survival.
Highlights
Gastric cancer is one of the most common cancers worldwide, and the incidence is high in Asian countries, including China [1]
Metastasectomy plus chemotherapy was associated with survival benefits in patients with Krukenberg tumors from gastric cancer
Clinicopathologic characteristics of gastric cancer with synchronous or metachronous ovarian metastasis are listed in Tables 1 and 2, respectively
Summary
Gastric cancer is one of the most common cancers worldwide, and the incidence is high in Asian countries, including China [1]. Ovarian metastasis (Krukenberg tumor) is usually seen in female patients, including synchronous metastasis, and metachronous metastasis after curative resection of gastric cancer [2]. Ovarian metastasis is associated with poor prognosis, and is one of the most important causes of treatment failure for gastric cancer in female patients [5]. The optimal treatment strategy for Krukenberg tumors from gastric cancer had not been clearly established. This study was conducted to determine associations between metastasectomy of Krukenberg tumors, clinicopathological features, and survival outcome, and provide optimal treatment strategy for these patients. This study aimed to explore the survival benefit of metastasectomy plus chemotherapy over chemotherapy alone in the treatment of Krukenberg tumors arising from gastric cancer and to identify prognostic factors
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