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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 3/2016

01-09-2016 | Gynecologic Oncology

Feto-maternal outcomes of pregnancy complicated by Krukenberg tumor: a systematic review of literature

Authors: Michiko Kodama, Aida Moeini, Hiroko Machida, Erin A. Blake, Brendan H. Grubbs, Koji Matsuo

Published in: Archives of Gynecology and Obstetrics | Issue 3/2016

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Abstract

Purpose

Krukenberg tumor is a rare type of ovarian cancer with a poor prognosis, and little is known about its behavior during pregnancy.

Methods

A systematic review was conducted to identify pregnancies complicated by Krukenberg tumor, correlated to oncologic and neonatal outcomes (n = 35).

Results

Mean age of cases was 30.4 years, and the most common origin of primary cancer was the stomach (68.6 %) followed by the colon (14.3 %). The two most common presenting symptoms were abdominal/pelvic pain (51.4 %) and nausea/vomiting (48.6 %). Two-thirds of tumors were bilateral (65.7 %) and the average size was 16.7 cm. Ascites (45.7 %), carcinomatosis (25.7 %) and non-ovarian distant metastases (14.3 %) were found at the time of surgery. Chemotherapy was administered in 20 cases, with fetal exposure in two of these. The ovarian tumor was identified prior to the primary cancer diagnosis in all 28 cases. The overall number of live births was 27 (81.8 %). The median survival was 6 months after Krukenberg tumor diagnosis. In univariate analysis, decreased overall survival was associated with dyspnea, ascites, carcinomatosis, non-radical surgery for the primary cancer, and residual disease at surgery (all, p < 0.05). On multivariate analysis, dyspnea and carcinomatosis remained independent prognostic factors for decreased overall survival after Krukenberg tumor diagnosis (2-year overall survival rates, dyspnea 0 vs. 56.6 %, adjusted-hazard ratio [HR] 9.74, 95 % confidence interval [CI] 2.04–46.2, p < 0.01; and carcinomatosis, 0 vs. 58.1 %, adjusted-HR 7.95, 95 % CI 1.76–36.0, p < 0.01).

Conclusions

Our results showed that prognosis of Krukenberg tumor complicated pregnancies is extremely poor, however it may be improved if radical surgery is achievable.
Appendix
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Metadata
Title
Feto-maternal outcomes of pregnancy complicated by Krukenberg tumor: a systematic review of literature
Authors
Michiko Kodama
Aida Moeini
Hiroko Machida
Erin A. Blake
Brendan H. Grubbs
Koji Matsuo
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4048-3

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