Krukenberg Tumor Confirmed by Surgery during the Follow-up after a Primary Resection of Colorectal Cancer

ABSTRACT

PURPOSE: We performed this study to evaluate the clinical presentation of, as well as the surgical intervention for, ovarian metastasis from colorectal cancers identified during postoperative follow-up. METHODS: Twelve cases (2.4%) of ovarian metastasis were observed among retrospective chart review of 493 females patients who underwent a resection of colorectal cancer between 1981 and 2006. The covariates used for the survival analysis were patient age at the time of ovarian relapse, size of the tumor, initial TMN stage of the colon cancer, the interval to metastasis, and the presence of gross residual disease after treatment for a Krukenberg tumor. The cumulative survival curves for the patient groups were calculated with the Kaplan-Meier method and were compared by means of the Log-Rank test. RESULTS: The average age of the patients was 48.9 years, ranging from 24 to 71 years, and the average survival time of the 12 patients was 19.6 months (estimated 3-year survival rate was 16.7%), with a range of 3 to 59 months after the diagnosis of a Krukenberg tumor. The survival rate for patients without gross residual disease was longer than that of patients with gross residual disease (P=0.0003). In contrast, patient age, size of the ovarian tumor, initial stage of the colon adenocarcinoma, and interval to metastasis were not prognostic indicators for survival after the development of ovarian metastasis. CONCLUSIONS: Our results suggest that, in general, most cases with ovarian metastasis have poor prognosis and that the absence of residual disease after treatment is a favorable prognostic factor in cases of a Krukenberg tumor of colon origin.