J Korean Med Sci.  2015 Jan;30(1):66-73. 10.3346/jkms.2015.30.1.66.

A Clinical Analysis of Brain Metastasis in Gynecologic Cancer: A Retrospective Multi-institute Analysis

• Kim YZ
• Kwon JH
• Lim S

• KMID: 2155449
• DOI: http://doi.org/10.3346/jkms.2015.30.1.66

Abstract

This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.

Keyword

Brain Metastasis; Ovarian Neoplasm; Uterine Cervical Neoplasm; Uterine Neoplasm, Outcome

MeSH Terms

Adult
Aged
Brain/*pathology
Brain Neoplasms/*mortality/*secondary/therapy
Chemoradiotherapy
Female
Genital Neoplasms, Female/*mortality/pathology/therapy
Humans
Middle Aged
Multivariate Analysis
Ovarian Neoplasms/mortality/pathology/therapy
Prognosis
Retrospective Studies
Uterine Cervical Neoplasms/mortality/pathology/therapy
Uterine Neoplasms/mortality/pathology/therapy
Young Adult

Figure

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  Fig. 1 The overall survival curve of BM patients with gynecologic cancer based on Kaplan-Meier survival estimates.

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  Fig. 2 The overall survival curve of BM patients with gynecologic cancer based on factors influencing the survival time: (A) age ( ≥ 65 yr vs. < 65 yr), (B) the type of gynecologic cancer, (C) the Karnofsky performance score ( ≥ 70 vs. < 70), (D) extracranial metastasis (presence vs. absence), (E) the primary cancer status (well controlled vs. poorly controlled), (F) the recursive partitioning analysis class, (G) the timing of brain metastasis (synchronous vs. metachronous), (H) the BM number (single vs. multiple), (I) the purpose of treatment (supportive vs. palliative), and (J) therapeutic modalities.

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