Clinicopathological characteristics, management, and survival outcomes of Krukenberg tumors : a systematic review of case reports and case series with individual patient data

Clinically, Krukenberg tumors represent stage IV disease, are frequently mistaken preoperatively for primary ovarian cancer, carry a poor prognosis, and lack an evidence-based standard of care: the roles of ovarian metastasectomy and the sequencing of systemic therapy remain unresolved, and guidance is largely derived from retrospective series. A previous systematic review synthesized the clinicopathological characteristics of Krukenberg tumors (Lionetti R, et al. Clinics and pathology of Krukenberg tumor. Minerva Obstet Gynecol. 2022;74(4):356–363; https://pubmed.ncbi.nlm.nih.gov/33944524/), and meta-analyses have examined metastasectomy in gastric-cancer ovarian metastases (e.g., https://pubmed.ncbi.nlm.nih.gov/31050365/). The present review will focus on gastrointestinal and breast origins using descriptive patient-level extraction. Its overlap with, and additional contribution beyond, prior reviews will be assessed through full-text comparison during the review.