Clinical Analysis Of 92 Patients Of Krukenberg Tumor And Two Cases Reports

Background and purpose:Ovarian metastatic tumors refer to tumors formed by other organs or tissues that have metastasized to the ovary,accounting for 5%-10% of ovarian tumors.The most common ovarian metastatic tumor is Krukenberg tumor.The clinical specificity of Krukenberg tumor is atypical,it is easy to be misdiagnosed,and it is easy to ignore the diagnosis and treatment of the primary lesion,which affects the prognosis.In addition,the primary lesions of individual cases of Krukenberg tumor are hidden,which is difficult to determine,increasing the difficulty in diagnosing and treating of Krukenberg tumor.Therefore,this study summarizes and analyzes the clinical data of92 patients with Krukenberg tumor in our hospital,and summarizes the pathological characteristics,together with two case reports of Kukenberg tumor with hidden primary lesions,and explores the clinical aspects of features,diagnosis,prognostic analysis,hoping to help the clinic.Materials and methods:This study retrospectively analyzed patients with ovarian metastatic tumors admitted to the Department of Gynecology,the First Affiliated Hospital of Dalian Medical University from June 1997 to June 2019,and patients who met the inclusion criteria.The clinical data,pathological types,and follow-up data were collected.The clinical data include the age of onset of ovarian metastatic tumors,whether menopause,first symptoms,the location of the primary tumor,the size of the lesion,the size of the metastatic tumor,the size of the lesion,the treatment method,etc.The follow-up data include survival time.SPSS 23.0 statistical software was used to perform the t test,and Kaplan-Meier method was used to describe the survival curve.The log-rank test was used to compare the single factors that may affect survival.The Cox proportional hazard regression model was used to perform multivariate analysis.Differences between groups were compared by chi-square test.p <0.05 was considered statistically significant.Result:A total of 92 patients with Krukenberg tumor met the inclusion criteria.The median age of onset was 52 years,and 49% were menopause.The first symptoms were mainly abdominal pain and mass.Both sides of the ovarian metastases can occur,and There was about 53.3% cases of unilateral ovarian disease.The average size of metastatic ovarian lesions was 12.54 ± 12.34 cm,and 81% of ovarian metastases were larger than 5cm in diameter.Gastrointestinal metastasis was the primary source of tumor metastasis.The gastric origin and colorectal origin were 33 cases and 36 cases,accounting for 75%.The average size of primary lesions was 5.25 ± 3.12 cm,and the smallest lesion size was 1 * 0.7cm.The pathological types of ovarian metastases are mainly signet ring cell carcinoma,accounting for about 57%,mucinous adenocarcinoma,12%,followed by high,low,and differentiated adenocarcinoma.Other special pathological types include:transitional cell carcinoma,metastatic breast invasive ductal carcinoma,Celiac liposarcoma involves the ovary,poorly differentiated adenocarcinoma with hepatoid adenocarcinoma differentiation,metastatic high-grade urothelial carcinoma,ovarian mucinous cystadenomas with melanoma,and low-grade peritoneal pseudomyxoma.For the treatment of 92 cases of Krukenberg tumor,47 cases were identified as the primary tumor before surgery,accounting for 51%,36 cases were identified after surgery,and 9 cases were unknown.There were 51 patients who underwent systemic resection and chemotherapy at the same time for primary tumors and metastases,25 patients with incomplete systemic resection and adjuvant systemic chemotherapy,3with traditional Chinese medicine,and 13 patients with follow-up observation.The follow-up deadline was June 2019,with a median survival time of 8 months for patients with Krukenberg tumors.The primary site(P = 0.038)and type of ovarian pathology(P = 0.039)of Krukenberg tumor are related to prognostic survival time.The primary site of the tumor is an independent prognostic factor for Krukenberg tumor.Conclusion:1.The distant ovarian metastasis can occur in a small gastrointestinal tumor of the lesion.Therefore,it is necessary to look for the primary foci in the case of ambiguous Krukenberg tumors.2.The primary site of a patient with Krukenberg tumor may be an independent risk factor that affects the survival prognosis of the patient.3.The survival time of patients with colorectal-derived Krukenberg tumors is greater than that of patients with gastric-derived metastases.4.Radical surgical resection of the primary lesion combined with chemotherapy can improve the prognosis of patients with Krukenberg tumor.