J Gastric Cancer 2011;11(1):31-37 DOI:10.5230/jgc.2011.11.1.31 Original Article Metachronous Ovarian Metastases Following Resection of the Primar y Gastric Cancer Si-Youl Jun, and Jong Kwon Park1 Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 1Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Purpose: We performed this study to evaluate the clinical presentation as well as the proper surgical intervention for ovarian metastasis from gastric cancers and these tumors were identified during postoperative follow-up. This will help establish the optimal strategy for im- proving the survival of patients with this entity. Materials and Methods: 22 patients (3.2%) with ovarian metastasis were noted when performing a retrospective chart review of (693) females patients who had undergone a resection for gastric cancer between 1981 and 2008. The covariates used for the survival analy- sis were the patient age at the time of ovarian relapse, the size of the tumor, the initial TNM stage of the gastric cancer, the interval to metastasis and the presence of gross residual disease after treatment for Krukenberg tumor. The cumulative survival curves for the pa- tient groups were calculated with the Kaplan-Meier method and they were compared by means of the Log-Rank test. Results: The average age of the patients was 48.6 years (range: 24 to 78 years) and the average survival time of the 22 patients was 18.8 months (the estimated 3-year survival rate was 15.8%) with a range of 2 to 59 months after the diagnosis of Krukenberg tumor. The survival rate for patients without gross residual disease was longer than that of the patients with gross residual disease (P=0.0003). In contrast, patient age, the size of ovarian tumor, the initial stage of gastric adenocarcinoma, the interval to metastasis and adjuvant chemotherapy were not prognostic indicators for survival after the development of ovarian metastasis. Conclusions: Early diagnosis and complete resection are the only possible hope to improve survival. As the 3-year survival rate after re- section of Krukenberg tumor is 15.8%, it seems worthwhile to consider performing tumorectomy as the second cytoreduction. Key Words: Krukenberg tumor, Stomach neoplasms, Survival Introduction (1,2) Numerous studies on Krukenberg tumor have been reported in Korea and other countries, nonetheless, most of them are on The prognosis of ovarian metastases or Krukenberg tumor is synchronous Krukenberg tumors, and there are relatively few stud- known to be poor. Different from the West, it is not rare disease in ies on the incidence and treatment outcomes of metachronous Korea as it is tumor that has metastasized from gastric cancer and Krukenberg tumor that developed during the postsurgical follow- gastric cancer is prevalent in Korea. Krukenberg tumor occur in up observation period. It has been reported that the incidence 0.3~6.7% of the operated gastric cancer patients, and its incidence of Krukenberg tumor detected during the follow-up observa- is much higher in the autopsies of gastric cancer patients (33~41%). tion period after radical gastric resection or the second surgery is Correspondence to: Si-Youl Jun Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung-dong, Changwon 630-723, Korea Tel: +82-55-290-6014, Fax: +82-55-290-6584 E-mail: ncnanmc@yahoo.co.kr Received August 11, 2010 Accepted October 10, 2010 This study was sponsored by Hyoseok Research Fund. 3~4.4％, the median survival time is 12.4~17 months,(3,4) and the incidence and prognosis are slightly different depending on the reports. Therefore, we analyzed the incidence of Krukenberg tumor that developed during the follow-up observation period after the resection of the primary gastric cancer, and the clinicopathological features of the Krukenberg tumors were confirmed by the second surgery. The treatment methods, the survival rate and the factors mediating effects on them were examined. Copyright © 2011 by The Korean Gastric Cancer Association www.jgc-online.org