Central nervous system metastasis in gynecologic cancers: Seeking the prognostic factors.
Journal
Journal of cancer research and therapeutics
ISSN: 1998-4138
Titre abrégé: J Cancer Res Ther
Pays: India
ID NLM: 101249598
Informations de publication
Date de publication:
01 Jan 2023
01 Jan 2023
Historique:
received:
28
02
2022
accepted:
27
06
2022
medline:
1
1
2023
pubmed:
1
1
2023
entrez:
22
2
2024
Statut:
ppublish
Résumé
Central nervous system (CNS) metastasis originating from gynecological cancer is a very rare and late manifestation of the disease. Therefore, there is still limited data on prognostic factors for survival. The objective of the present study is to identify prognostic factors for survival in patients with CNS metastasis originating from gynecological cancer. The present retrospective study analyzed the patients with gynecological cancers who were treated due to CNS metastases between January 1999 and December 2019 at Istanbul University Hospital. Forty-seven patients with CNS metastasis of gynecological origin were included in the study. The median age at the time of CNS metastasis was 59 (range 34-93). The median time from initial cancer diagnosis to CNS metastasis was 24.9 (range: 0-108.2) months. Most patients had epithelial ovarian cancer (EOC) (76.6%), followed by endometrial cancer (EC) (14.8%), cervical cancer (CC) (4.3%), and vulvar cancer (VC) (4.3%). By multivariate analysis, the presence of extracranial metastasis (HR: 5.10; 95% CI: 1.71-15.18), Eastern Cooperative Oncology Group (ECOG) performance status ≥3 (HR: 2.92; 95% CI: 1.36-6.26), palliative care only for the treatment of CNS metastasis (HR: 1.47; 95% CI: 0.58-4.11), and treatment-free interval (TFI) <6 months (HR: 2.74; 95% CI: 1.23-6.08) were independent factors that associated with worse survival. Patients with CNS metastasis who have favorable prognostic factors are considered to be appropriate candidates for aggressive and long-term treatment strategies. Extracranial metastasis, ECOG performance status, treatment history of CNS metastasis, and TFI were determined as independent prognostic factors that improved survival. TFI might be taken into account as a prognostic factor for patients with CNS metastasis in gynecological cancer.
Identifiants
pubmed: 38384014
doi: 10.4103/jcrt.jcrt_499_22
pii: 01363817-202319002-00010
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S523-S529Informations de copyright
Copyright © 2023 Copyright: © 2023 Journal of Cancer Research and Therapeutics.
Références
Schouten LJ, Rutten J, Huveneers HA, Twijnstra A. Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 2002;94:2698–705
Piura E, Piura B. Brain metastases from ovarian carcinoma. ISRN Oncol 2011 2011; 527453
Piura E, Piura B. Brain metastases from endometrial carcinoma. ISRN Oncol 2012 2012; 581749
Piura E, Piura B. Brain metastases from cervical carcinoma: Overview of pertinent literature. Eur J Gynaecol Oncol 2012;33:567–73
Ogawa K, Yoshii Y, Aoki Y, Nagai Y, Tsuchida Y, Toita T, et al. Treatment and prognosis of brain metastases from gynecological cancers. Neurol Med Chir (Tokyo) 2008;48:57–62. discussion 62-3
Hasegawa H, Yamamoto M, Shin M, Barfod BE. Gamma knife radiosurgery for brain vascular malformations: Current evidence and future tasks. Ther Clin Risk Manag 2019;15:1351–67
Markesbery WR, Brooks WH, Gupta GD, Young AB. Treatment for patients with cerebral metastases. Arch Neurol 1978;35:754–6
Sperduto PW, Mesko S, Li J, Cagney D, Aizer A, Lin NU, et al. Beyond an updated graded prognostic assessment (Breast GPA): A prognostic index and trends in treatment and survival in breast cancer brain metastases from 1985 to today. Int J Radiat Oncol Biol Phys 2020;107:334–43
Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X, et al. Summary report on the graded prognostic assessment: An accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 2012;30:419–25
Hall WA, Djalilian HR, Nussbaum ES, Cho KH. Long-term survival with metastatic cancer to the brain. Med Oncol 2000;17:279–86
Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, Wasserman T, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997;37:745–51
Sperduto PW, Chao ST, Sneed PK, Luo X, Suh J, Roberge D, et al. Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: A multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 2010;77:655–61
Zindler JD, Rodrigues G, Haasbeek CJ, De Haan PF, Meijer OW, Slotman BJ, et al. The clinical utility of prognostic scoring systems in patients with brain metastases treated with radiosurgery. Radiother Oncol 2013;106:370–4
Siu G, Springer EA, Hedrick SM. The biology of the T-cell antigen receptor and its role in the skin immune system. J Invest Dermatol 1990;94 6 Suppl: 91S–100S
Borella F, Bertero L, Morrone A, Gambella A, Bovetti M, Cosma S, et al. Brain metastases from ovarian cancer: Current evidence in diagnosis, treatment, and prognosis. Cancers (Basel) 2020;12:2156
Nasu K, Satoh T, Nishio S, Nagai Y, Ito K, Otsuki T, et al. Clinicopathologic features of brain metastases from gynecologic malignancies: A retrospective study of 139 cases (KCOG-G1001s trial). Gynecol Oncol 2013;128:198–203
Takeshita S, Todo Y, Furuta Y, Okamoto K, Minobe S, Yamashiro K, et al. Prognostic factors for patients with brain metastasis from gynecological cancer: A significance of treatment-free interval of more than 6 months. Jpn J Clin Oncol 2017;47:604–10
Marchetti C, Ferrandina G, Cormio G, Gambino A, Cecere S, Lorusso D, et al. Brain metastases in patients with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19). Gynecol Oncol 2016;143:532–8
Walter AC, Gunderson CC, Vesely SK, Algan O, Sughrue M, Slaughter KN, et al. Central nervous system metastasis in gynecologic cancer: Symptom management, prognosis and palliative management strategies. Gynecol Oncol 2015;136:472–7
Rades D, Fischer D, Veninga T, Stalpers LJ, Schild SE. Prognostic factors for survival and intracerebral control after irradiation for brain metastases from gynecological cancer. Gynecol Oncol 2009;114:506–8
Gressel GM, Lundsberg LS, Altwerger G, Katchi T, Azodi M, Schwartz PE, et al. Factors predictive of improved survival in patients with brain metastases from gynecologic cancer: A single institution retrospective study of 47 cases and review of the literature. Int J Gynecol Cancer 2015;25:1711–6
Keskin S, Kucucuk S, Ak N, Atalar B, Sari M, Sozen H, et al. Survival impact of optimal surgical cytoreduction in recurrent epithelial ovarian cancer with brain metastasis. Oncol Res Treat 2019;42:101–6
Growdon WB, Lopez-Varela E, Littell R, Oliva E, Seiden M, Krasner C, et al. Extent of extracranial disease is a powerful predictor of survival in patients with brain metastases from gynecological cancer. Int J Gynecol Cancer 2008;18:262–8
Kim YZ, Kwon JH, Lim S. A clinical analysis of brain metastasis in gynecologic cancer: A retrospective multi-institute analysis. J Korean Med Sci 2015;30:66–73
Anupol N, Ghamande S, Odunsi K, Driscoll D, Lele S. Evaluation of prognostic factors and treatment modalities in ovarian cancer patients with brain metastases. Gynecol Oncol 2002;85:487–92
Geisler JP, Geisler HE. Brain metastases in epithelial ovarian carcinoma. Gynecol Oncol 1995;57:246–9
Cormio G, Maneo A, Colamaria A, Loverro G, Lissoni A, Selvaggi L. Surgical resection of solitary brain metastasis from ovarian carcinoma: An analysis of 22 cases. Gynecol Oncol 2003;89:116–9
Kawana K, Yoshikawa H, Yokota H, Onda T, Nakagawa K, Tsutsumi O, et al. Successful treatment of brain metastases from ovarian cancer using gamma-knife radiosurgery. Gynecol Oncol 1997;65:357–9
Alexander E 3rd, Moriarty TM, Davis RB, Wen PY, Fine HA, Black PM, et al. Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Natl Cancer Inst 1995;87:34–40
Park SH, Ro DY, Park BJ, Kim YW, Kim TE, Jung JK, et al. Brain metastasis from uterine cervical cancer. J Obstet Gynaecol Res 2010;36:701–4
Niu X, Rajanbabu A, Delisle M, Peng F, Vijaykumar DK, Pavithran K, et al. Brain metastases in women with epithelial ovarian cancer: Multimodal treatment including surgery or gamma-knife radiation is associated with prolonged survival. J Obstet Gynaecol Can 2013;35:816–22
Pakneshan S, Safarpour D, Tavassoli F, Jabbari B. Brain metastasis from ovarian cancer: A systematic review. J Neurooncol 2014;119:1–6