Krukenberg Tumors: Does Surgical Resection Improve Survival?

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Krukenberg tumors are ovarian metastases characterized by signet ring cells, often originating from gastric or colorectal cancers.
• They constitute a significant portion of malignant ovarian neoplasms, with treatment modalities debated between systemic therapy and surgery.
• Optimal management strategies require further investigation to improve patient outcomes.

Purpose of the Study:

• To evaluate the role of cytoreductive surgery in managing Krukenberg tumors.
• To assess the impact of surgical resection on overall survival (OS) and disease-free survival (DFS).
• To identify prognostic factors influencing survival in patients with Krukenberg tumors.

Main Methods:

• Retrospective cohort study of 84 patients diagnosed with Krukenberg tumors between July 2015 and August 2021.
• Analysis of demographic, preoperative, operative, postoperative, pathologic, and oncologic follow-up data.
• Multivariate analysis to determine factors affecting OS and DFS.

Main Results:

• Colorectal cancer was the most common primary site (52.4%).
• Median OS was 20 months. Breast primary, resection of both primary and Krukenberg tumor, and R0 resection were associated with improved OS.
• Median DFS post-R0 resection was 32 months; peritoneal/omental metastasis was a negative predictor for DFS.

Conclusions:

• Cytoreductive surgery, especially achieving R0 resection, significantly enhances overall survival in Krukenberg tumor patients.
• Successful R0 resection is linked to improved disease-free survival, particularly in the absence of concomitant peritoneal or omental metastasis.