Krukenberg Tumors of Gastric Origin: The Rationale of Surgical Resection and Perioperative Treatments in a Multicenter Western Experience

Rosa, Fausto; Marrelli, Daniele; Morgagni, Paolo; Cipollari, Chiara; Vittimberga, Giovanni; Framarini, Massimo; Cozzaglio, Luca; Pedrazzani, Corrado; Berardi, Stefano; Baiocchi, Gian Luca; Roviello, Franco; Portolani, Nazario; Manzoni, Giovanni De; Costamagna, Guido; Doglietto, Giovanni Battista; Pacelli, Fabio

doi:10.1007/s00268-015-3326-8

Cited by 51 publications

(58 citation statements)

References 24 publications

(27 reference statements)

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“…Six of the 12 included articles reported about the timing of presentation [7,8,26,27,31,33], and 6 articles included the disease location [7,8,26,27,34,36]. mKT from gastric cancer presented at a median time of 16-21.4 months according to the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Six articles reported the percentage of patients undergoing systemic treatment after surgical therapy [7,8,26,31,34,36]. 53-100% of patients underwent systemic adjuvant chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…There was no disagreement regarding eligibility of full-text articles (Cohen's kappa = 1). Finally, a total of 13 articles dated between 2002 and 2017 fulfilled the selection criteria and were therefore included in this systematic review [7,8,26,27,28,29,30,31,32,33,34,35,36]; this pool of articles consisted of 13 retrospective reports. Characteristics of the included studies are summarized in table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Ovarian relapse after gastrectomy with curative intent is not rare and is one of the most common causes of treatment failure [5,6]. The incidence of ovarian metastasis after curative resection of gastric cancer is approximately 0.3-6.7%, although some autopsy studies have reported incidence rates ranging from 33 to 41% [7,8]. Nowadays, most of the reports concerning metachronous presentation of KT (mKT) focus on incidence and clinicopathologic findings, intermixing metastasis from various organs rather than analyzing the possibility of offering a survival benefit using different treatment modalities [9,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Is a Surgical Approach Justified in Metachronous Krukenberg Tumor from Gastric Cancer? A Systematic Review

Aurello¹,

Berardi²,

Antolino³

et al. 2018

Oncol Res Treat

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Background: The treatment of metachronous Krukenberg tumor (mKT) from gastric cancer remains unexplored. We performed a literature review to evaluate whether or not surgical treatment improves survival. Methods: A systematic review according to PRISMA guidelines was performed. Studies reporting on patients who underwent surgical treatment for mKT from gastric cancer were selected. Metachronous disease was divided as follows: confined to the ovaries, confined to the pelvis, or beyond the pelvis. Outcomes evaluated included overall survival (OS), progression-free survival (PFS), resection rate (R0), and factors predicting survival. Results: 13 retrospective reports fulfilled the selection criteria (512 patients). Most of the patients presented at a premenopausal age. The median presentation interval from gastrectomy ranged from 16 to 21.4 months. Median OS ranged between 9 and 36 months. 1-year OS ranged between 52.5 and 59%, and 3-years OS between 9.8 and 36.5%. Resection margin, peritoneal seeding, and chemotherapy regimen and cycles influenced survival. Conclusion: Surgical treatment and adjuvant chemotherapy in patients with mKT from gastric cancer seems to be associated with improved survival and is justified especially in young patients. Disease location and R0 resection should be considered when selecting patients.

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Section: Resultsmentioning

confidence: 99%

“…Six articles reported the percentage of patients undergoing systemic treatment after surgical therapy [7,8,26,31,34,36]. 53-100% of patients underwent systemic adjuvant chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is a Surgical Approach Justified in Metachronous Krukenberg Tumor from Gastric Cancer? A Systematic Review

Aurello¹,

Berardi²,

Antolino³

et al. 2018

Oncol Res Treat

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“…We are observing an interesting phenomenon from a historical point of view; while 30 years ago the Japanese surgeons sustained an aggressive surgical approach to gastric cancer, which was subsequently accepted in the rest of the world, Western surgeons are actually more aggressive in this dissection nowadays than their Eastern counterpart. Other recently published papers, investigating Krukenberg tumors, margin infiltration and surgery in old patients, included as subgroup analysis number of patients with distant positive nodes, whose survival was not statistically different (when lymphadenectomy was done) from patients without nodal metastases in those basins (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Distant nodal metastasis: is it always an unresectable disease?

Baiocchi

Celotti

Molfino

et al. 2017

Transl. Gastroenterol. Hepatol.

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This article aims at analyzing the published literature concerning the treatment of patients with gastric cancer and distant nodal metastases, actually considered metastatic disease. A systematic search was undertaken using Medline, Embase, Cochrane and Web-of-Science libraries. No specific restriction on year of publication was used; preference was given to English papers. Both clinical series and literature reviews were selected. Only 11 papers address the issue of surgery for nodal basins outside the D2 dissection area. From these papers, in selected cases extended surgery may prove useful in prolonging survival, when a comprehensive therapeutic pathway including chemotherapy is scheduled. In conclusion, in presence of nodal metastases outside the loco-regional nodes, surgery may be considered for metastatic nodes in stations 13 and 16, in selected cases.

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The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

Wang

Zhang

et al. 2021

Cancer Communications

401

317

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There exist differences in the epidemiological characteristics, clinicopathological features, tumor biological characteristics, treatment patterns, and drug selections between gastric cancer patients from the Eastern and Western countries. The Chinese Society of Clinical Oncology (CSCO) has organized a panel of senior experts specializing in all sub‐specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually. Taking into account regional differences, giving full consideration to the accessibility of diagnosis and treatment resources, these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China. The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis, treatment, follow‐up, and screening of gastric cancer. Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines, this updated guideline integrates the results of major clinical studies from China and overseas for the past year, focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations. For the comprehensive treatment of non‐metastatic gastric cancer, attentions were paid to neoadjuvant treatment. The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated. For the comprehensive treatment of metastatic gastric cancer, recommendations for immunotherapy were included, and immune checkpoint inhibitors from third‐line to the first‐line of treatment for different patient groups with detailed notes are provided.

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Krukenberg Tumors of Gastric Origin: The Rationale of Surgical Resection and Perioperative Treatments in a Multicenter Western Experience

Abstract: KT remains a clinical challenge for gastric cancer therapy. The extent of disease and feasibility of removal of the metastatic lesion must be carefully evaluated prior to surgery to define the patients group who could benefit most from a resection associated with perioperative treatments.

Cited by 51 publications

References 24 publications

Is a Surgical Approach Justified in Metachronous Krukenberg Tumor from Gastric Cancer? A Systematic Review

Is a Surgical Approach Justified in Metachronous Krukenberg Tumor from Gastric Cancer? A Systematic Review

Distant nodal metastasis: is it always an unresectable disease?

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

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