Palliative surgery for Krukenberg tumors – 12-year experience and review of the literature

Table 1 Patient characteristics n (%)

Variable	Frequency
Age
≥ 50	25 (65.8)
< 50	13 (34.2)
Race
Chinese	33 (86.8)
Malay	3 (7.9)
Others	2 (5.3)
Presenting symptoms
Pain	15 (39.5)
Distension	9 (23.7)
Intestinal obstruction	3 (7.9)
Obstructive symptoms	3 (7.9)
Asymptomatic	8 (21.1)
ASA score at KT surgery
2	30 (78.9)
3	8 (21.1)

SD: Standard deviation; ASA: American Society of Anesthesiologists; KT: Krukenberg tumour.

Table 2 Disease characteristics n (%)

Variable	Frequency
Site of primary
Stomach	4 (10.5)
Colon	21 (55.3)
Rectum	1 (2.6)
Pancreas	3 (7.9)
Breast	2 (5.3)
Peritoneum	2 (5.3)
Appendix	1 (2.6)
Endometrium	1 (2.6)
Bladder	1 (2.6)
Lung	1 (2.6)
Unknown	1 (2.6)
Previous surgery for primary
Yes	17 (44.7)
No	21 (55.3)
Detection of KT and primary
Synchronous	18 (47.4)
Metachronous	20 (52.6)
KT size
≥ 12 cm	19 (50.0)
< 12 cm	19 (50.0)
Ovaries involved
Unilateral	20 (52.6)
Bilateral	18 (47.4)
Peritoneal metastases
Yes	21 (55.3)
No	17 (44.7)
Hepatic metastases
Yes	16 (42.1)
No	22 (57.9)

KT: Krukenberg tumour; SD: Standard deviation.

Table 3 Surgery characteristics n (%)

Variable	Frequency
Urgency
Elective	33 (86.8)
Emergency	5 (13.2)
Pre-KT surgery chemo
Yes	26 (68.4)
No	12 (31.6)
Surgery
USO	10 (26.3)
BSO	12 (31.6)
THBSO	16 (42.1)
Post-op clavien-dindo score
Grade 0	33 (86.8)
Grade I	2 (5.3)
Grade II	2 (5.3)
Grade IIIa	1 (2.6)

SD: Standard deviation; ASA: American Society of Anesthesiologists; KT: Krukenberg tumour; USO: Unilateral salphingo-opherectomy; BSO: Bilateral salphingo-opherectomy; THBSO: Total hysterectomy and bilateral salphingo-opherectomy.

Table 4 Univariate analyses of variables affecting survival

Variable	HR (95%CI)	P-value
Age < 50	2.169 (0.876-5.369)	0.094
ASA score 3	2.830 (0.873-9.171)	0.083
Colorectal primary	1.089 (0.424-2.795)	0.860
Previous surgery for primary	0.894 (0.359-2.226)	0.810
Synchronous lesion	1.240 (0.497-3.096)	0.645
Size ≥ 12 cm	1.106 (0.424-2.884)	0.837
Bilateral disease	1.473 (0.597-3.636)	0.400
Peritoneal metastases	1.337 (0.509-3.511)	0.555
Hepatic metastases	1.055 (0.419-2.656)	0.909
Emergency surgery	3.382 (1.051-10.89)	0.027
Pre-op chemotherapy	1.575 (0.521-4.758)	0.421
Serum CA 125 > 35 kU/L	0.750 (0.187-3.004)	0.684
Serum CEA ≥ 30 μg/L	0.785 (0.234-2.626)1	0.694a

¹Among patients with a colorectal primary only. HR: Hazard ratio; CI: Confidence interval; ASA: American Society of Anesthesiologists; CEA: Carcinoembryonic antigen.