Prognostic factors, surgical treatment and survival benefit. A literature review

Acknowledgement: This work received financial support through the project entitled “CERO Career profile: Romanian Researcher”, grant number POSDRU/159/1.5/S/ 135760, cofinanced by the European Social Fund for Sectoral Operational Programme Human Resources Development 2007-2013. The Krukenbergtumor (KT) represents a metastatic lesion to the ovary from a primary gastrointestinal tumor (GI) most frequently the stomach being the site from which the malignant cells disseminate to the ovaries. KT are generally bilateral metastatic ovarian tumors which are associated with a low overall survival rate and a poor prognosis. Usually, it develops in women at the age of 40-50 years. The purpose of this article is to review the prognostic factors for KT, the surgical treatment and its impact on survival in women with KT of the ovary. A Pubmed database search for English language articles using key words (e.g‘‘ovarian cancer”, “Krukenberg tumors’’, ‘‘treatment’’, ‘‘surgery) has been conducted. Systematic reviews, retroprospective studies, controlled and randomized clinical trials were selected if the research subjects were treated with surgery. Detection of a unilateral KT, the absence of any other metastases, the primary tumor originating in the colon or rectum as well as the identification of the primary GI tumor during the resection of the KT have been recognized as favourable prognostic factors associated with the postoperative evolution of women diagnosed with KT.A complete resection of the KT (negative margins, R0) improves the overall survival rate especially in women with colorectal cancer and no other medical or surgical comorbidities. In women with gastric cancer and metachronous KT, the absence of any other distant visceral metastastes represents an indication for the complete resection of the KT. Women with primary gastric cancer and KT s have generally a poor prognostic.