RESUMO
BACKGROUND: A Krukenberg tumour (KT) is defined as an ovarian metastasis from a gastrointestinal adenocarcinoma and suggests a terminal condition. This study aimed to identify the prognostic factors affecting the survival of patients with KTs of colorectal origin who receive cytoreductive surgery. METHODS: Medical records of patients who had received cytoreductive surgery and had been pathologically diagnosed with KT of colorectal origin in two centres were reviewed. Information about the patients' clinicopathological features and follow-up visit were collected. Factors influencing patient survival were analysed. RESULTS: Fifty-seven patients were included in this study. The median survival time was 35 months. Five-year overall survival was 25%. Patients who had recurrence 2 years after resection of the primary tumour, achieved complete cytoreduction, had metastases confined to the pelvis, had no lymph node involvement, and received systemic chemotherapy had a significantly longer median survival than those who had recurrence at the same time as resection of the primary tumour (P = 0.027), received incomplete cytoreduction (P < 0.001), had metastases beyond the pelvis (P < 0.001), had lymph node involvement (P = 0.011), and did not receive systemic chemotherapy (P = 0.006) on log-rank test. Less extensive metastatic disease, achievement of complete cytoreduction, and use of systemic chemotherapy were significantly associated with improved prognosis on multivariate analysis. CONCLUSIONS: Cytoreductive surgery may confer survival benefits in patients with KTs of colorectal origin who attain complete cytoreduction and whose metastases are confined to the pelvis and when combined with active systemic chemotherapy.
Assuntos
Neoplasias Colorretais/patologia , Tumor de Krukenberg/secundário , Recidiva Local de Neoplasia/patologia , Neoplasias Ovarianas/secundário , Adulto , Idoso , Neoplasias Colorretais/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Tumor de Krukenberg/terapia , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Neoplasias Ovarianas/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Adulto JovemRESUMO
The interaction energy between two like-charged colloid spheres with nonuniformly distributed surface charges immersed in a bulk electrolyte is calculated under the linearized Poisson-Boltzmann equation. The calculated results are sensitive to the relative orientations of the spheres due to the anisotropy of the distribution of charges on the sphere surface. The effective repulsive interaction after thermal average is weaker than the case when charges are uniformly distributed on the spheres, and with the increase of the nonuniformity, an attractive interaction between the two spheres emerges.
