Display options
Share it on

Gynecol Oncol Rep. 2020 Oct 31;34:100664. doi: 10.1016/j.gore.2020.100664. eCollection 2020 Nov.

Treatment patterns and outcomes among women with brain metastases from gynecologic malignancies.

Gynecologic oncology reports

Kristen Cagino, Ryan Kahn, Susan Pannullo, Hani Ashamalla, Susie Chan, Onyinye Balogun, Charlene Thomas, Paul J Christos, Kevin Holcomb, Melissa K Frey, Eloise Chapman-Davis

Affiliations

  1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York Presbyterian Weill Cornell Medical Center, New York, NY, USA.
  2. Department of Neurological Surgery, New York Presbyterian Weill Cornell Medical Center, New York, NY, USA.
  3. Department of Radiation Oncology, New York Presbyterian Brooklyn Methodist Hospital, New York, NY, USA.
  4. Department of Radiation Oncology, New York Presbyterian Weill Cornell Medical Center, New York, NY, USA.
  5. Department of Population Health Sciences, New York Presbyterian Weill Cornell Medical Center, New York, NY, USA.

PMID: 33204795 PMCID: PMC7649617 DOI: 10.1016/j.gore.2020.100664

Abstract

BACKGROUND: Brain metastasis secondary to gynecologic malignancy is rare and has no definitive management guidelines. In this descriptive study, we aimed to identify prognostic factors and treatments that may be associated with longer overall survival.

METHODS: Patients with brain metastases from gynecologic malignancies were identified between 2004 and 2019 at two institutions. Descriptive statistics were performed using N (%) and median (interquartile range). Univariate cox proportional hazards regression was performed to evaluate the effect of different factors on overall survival.

RESULTS: 32 patients presented with brain metastasis from gynecologic primaries (ovarian/fallopian tube/primary peritoneal n = 14, uterine n = 11, cervical n = 7). Median age of initial cancer diagnosis was 61 (34-79). At initial cancer diagnosis 83% of patients were Stage III/IV and underwent surgery (66%), chemotherapy (100%), and/or pelvic radiation (33%). Median time from initial cancer diagnosis to brain metastasis was 18 months. Treatment of brain metastasis with surgery and radiation compared to stereotactic radiosurgery or whole brain radiation therapy alone revealed a trend toward longer overall survival (p = 0.07). Time from initial cancer diagnosis to brain metastasis was associated with longer overall survival with each one-month increase from initial cancer diagnosis associated with a 7% reduction in risk of death (HR 0.93, 95% CI = 0.89-0.97, p = 0.01). Initial cancer treatment, stage, histology, and number of brain lesions did not affect overall survival.

CONCLUSIONS: Patients with brain metastasis secondary to gynecologic malignancies with the longest overall survival had the greatest lag time between initial cancer diagnosis and brain metastasis. Brain metastasis treated with surgery and radiation was associated with longer overall survival.

© 2020 The Authors.

Keywords: Brain metastasis; Stereotactic radiosurgery; Whole brain radiation therapy

References

  1. Pharmacol Res. 2005 Jul;52(1):25-33 - PubMed
  2. J Surg Oncol. 2001 Nov;78(3):194-200; discussion 200-1 - PubMed
  3. Radiat Oncol. 2013 Feb 15;8:36 - PubMed
  4. J Obstet Gynaecol Can. 2013 Sep;35(9):816-822 - PubMed
  5. Cancer. 2008 Nov 1;113(9):2610-4 - PubMed
  6. Brain Tumor Res Treat. 2017 Oct;5(2):87-93 - PubMed
  7. Open J Obstet Gynecol. 2016 Aug;6(9):544-552 - PubMed
  8. J Neurosurg Sci. 2019 Feb;63(1):61-82 - PubMed
  9. Gynecol Oncol. 2016 Jul;142(1):70-75 - PubMed
  10. Lancet Oncol. 2016 Jul;17(7):976-983 - PubMed
  11. J Neurosurg. 1987 Nov;67(5):697-705 - PubMed
  12. J Neurooncol. 2018 Feb;136(3):545-553 - PubMed
  13. MAbs. 2011 Mar-Apr;3(2):153-60 - PubMed
  14. J Clin Oncol. 2018 Feb 10;36(5):483-491 - PubMed
  15. Gynecol Oncol. 2016 Dec;143(3):532-538 - PubMed

Publication Types

Grant support