Analysis of prognosis factors and follow-up strategy of ovary metastasis derived from gastric and colorectal cancer
10.3760/cma.j.issn115396-20210617-00228
- VernacularTitle:胃肠恶性肿瘤合并卵巢转移的预后因素及随访策略分析
- Author:
Xiaoye LIU
1
;
Xiaobao YANG
;
Xi WANG
;
Jie YIN
;
Jun ZHANG
;
Hongwei YAO
;
Yingchi YANG
;
Zhongtao ZHANG
Author Information
1. 首都医科大学附属北京友谊医院普通外科，国家消化系统疾病临床医学研究中心 100050
- Keywords:
Krukenberg tumor;
Ovary;
Stomach neoplasms;
Colorectal neoplasms;
Cytoreductive surgery
- From:
International Journal of Surgery
2021;48(8):560-564
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the prognostic factors of Krukenberg tumors derived from the gastric cancer and colorectal cancer, so as to guide comprehensive treatment; looking for objective and sensitive indicators of ovarian metastasis during the follow-up after the surgery for gastric and colorectal cancer, which provides a basis for early diagnosis.Methods:Retrospectively analyzed the clinical data of 75 patients diagnosed with Krukenberg tumor admitted to Beijing Friendship Hospital, Capital Medical University from June 2007 to February 2020. Log-rank method and COX regression analysis were used to find independent prognostic factors. Wilcoxon rank sum test was used to compare the dynamic changes of ovarian imaging and tumor markers and to find the more sensitive indicators in the follow-up of patients with metachronous metastasis.Results:In the 75 cases, the univariate analysis suggested that CA19-9≥123.5 U/mL ( P=0.001), CA12-5≥37.9 U/mL ( P=0.018), Krukenberg tumor of stomach origin ( P=0.037), extra-ovary metastasis ( P=0.014), and without cytoreductive surgery (CRS) ( P<0.001)were poor prognostic factors. Among them, cytoreductive surgery could significantly improve the prognosis, even if with visible residual lesions, the overall survival was still significantly longer than those who have not undergone cytoreductive surgery ( P=0.004). Multivariate analysis results showed that CA19-9 and cytoreductive surgery ( P=0.001) were independent prognostic factors for patients with Krukenberg tumor; during the postoperative follow-up, ultrasound and CT imaging changes were more sensitive to ovarian metastasis ( P=0.006). Conclusions:CRS can prolong significantly the overall survival (OS) of patients with krukenberg tumor. Patients with simultaneous metastases should not give up the opportunity for surgery, and patients with metachronous metastases should also receive ovary resection procedure, even if with visible residual lesions, the patients can still benefit from the procedure. In the follow-up for gastric and colorectal cancer, attention should be paid to the ovarian ultrasound and CT imaging changes to facilitate early detection of ovarian metastases.
