Objective   This work aimed to explore the clinicopathologic characteristics and prognostic factors of gastric cancer patients with metachronous ovarian metastasis.

  Methods   The clinicopathologic data of 63 post-operative gastric cancer patients with the complication of metachronous ovarian metastasis were collected.The patients were admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing from January 1999 to December 2011.Log-rank test was conducted for survival analyses.Univariate analysis was used for possible prognostic factors affecting the survivals.Cox regression model was used for multivariate analysis.

  Results   The incidence of ovarian metastasis was 3.4% with a mean age of 45 years.Among all patients, 65.1% were pre-menopausal.The mean time interval between ovarian metastasis and primary cancer was 16 months.Low-differentiated carcinoma ranked first in the primary gastric cancers.The majority of lesions occurred in the serous membrane(87.3%).The metastatic sites included N2-3 lymph node(68.3%), bilateral ovaries(85.7%), and peritoneal membrane(73%).Total resection of metastasized sites was performed(31.7%).The overall median survival was 13.6 months, whereas the overall 1-, 2-, and 3-year survival rates were 52.5%, 22.0%, and 9.8%, respectively.The 5-year survival rate was zero.Univariate analysis showed that the patient's prognosis was correlated with peritoneal seeding metastasis, vascular tumor embolus, range of lesion excision, and mode of comprehensive treatment with adjuvant chemotherapy(P < 0.05).Multivariate analysis indicated that peritoneal seeding metastasis was an independent prognostic factor for gastric cancer patients with ovarian metastasis(P < 0.01).

  Conclusion   Effective control of peritoneal seeding-induced metastasis is important in improving the prognosis of the gastric cancer patients with ovarian metastasis.