Krukenberg tumors: Can management be improved?

Objective: The Montefiore Medical Center experience with women with gastroi ntestinal (GI) cancer was reviewed to: (1) evaluate clinical parameters in patients with Krukenberg tumor (GI cancer metastatic to the ovaries) and (2 ) evaluate oophorectomy in GI cancer patients. Methods: (1) Charts of all f emale patients admitted between 1985 and 1996 with gastric or colon cancer were reviewed. Results: The frequency of Krukenberg tumor was 7/1,021 (0.7% ). The median age at presentation was 39.5 years (range 35-80); 5 were prem enopausal, 2 of whom were postpartum. Krukenberg tumor was significantly mo re common in the premenopausal patients with gastric cancer (p = 0.002), co lon cancer (p = 0.001), and in both sites combined (p< 0.001). Our rate of pregnancy-associated Krukenberg tumors (28.6%) was significantly higher (p < 0.05) than that found in 4 of 5 large studies. The average survival of ou r 7 patients was 12.3 months (range 4 days to 26 months), with secondary de bulking and chemotherapy offering 1 patient the longest longevity. Only 19/ 788 (2.4%) women had oophorectomy during their colon cancer surgery reveali ng 2 (10.5%) Krukenberg tumors, 6 (31.6%) benign solid or cystic ovarian tu mors, and 11 (57.9%) normal or atrophic ovaries. Conclusions: Krukenberg tu mors are rare. There is no uniformity of data reported in the literature. K rukenberg tumors were more common in premenopausal women with gastric or co lon cancer compared to postmenopausal women. Our rate of pregnancy-associat ed Krukenberg tumors appeared to be higher compared to other studies. Proph ylactic oophorectomy in pre- and postmenopausal women should be considered at the time of GI cancer surgery, and requires further study. A national re gistry combined with prospective, multisite studies are needed to gather da ta and evaluate treatment.