Brain Tumor Res Treat.  2017 Oct;5(2):87-93. 10.14791/btrt.2017.5.2.87.

Outcomes in 20 Gynecologic Cancer Patient with Brain Metastasis: A Single Institution Retrospective Study

• Kim SB
• Hwang K
• Joo JD
• Han JH
• Kim YB
• Kim CY

• KMID: 2396452
• DOI: http://doi.org/10.14791/btrt.2017.5.2.87

Abstract

BACKGROUND
The incidence of brain metastasis (BM) in gynecologic cancers has risen recently, due to prolonged survival times and an early diagnosis. We analyzed treatment outcomes of patients with BM from gynecologic cancers.
METHODS
Among 951 patients with BM who were treated in neurosurgical department from July 2003 to February 2016, a total of 20 (2%) patients were from gynecologic cancers. The patients' clinical characteristics were collected by using medical records. There were 14 (66.7%) ovarian cancers, 4 (19.0%) uterine cancers, and 2 (9.5%) cervical cancers. As a primary treatment modality, 11 patients were treated with Gamma Knife surgery (GKS), 6 with surgical resection followed by whole brain radiation therapy (WBRT), and 3 with WBRT only. Overall and progression-free survival according to the primary origin and the primary treatment were analyzed.
RESULTS
Median overall survival time was 28 months, and progression-free survival was 15 months. In patients with ovarian cancer, median overall survival did not reach during the follow-up periods and progression-free survival time was 15 months. Median overall survival time in patients who received GKS as the primary treatment was 17 months and that in patients who underwent surgical resection followed by WBRT was 37.3 months (p=0.16). The median value of progression-free survival time in patients who received GKS as the primary treatment was 12 months and that in patients who underwent surgical resection with WBRT was 42 months (p=0.042). Median follow up period of over all patients was 13 months.
CONCLUSION
BM from gynecologic cancer is rare (2%), but our findings suggest that the prognosis might not always be poor. In our small series, surgical resection with WBRT was a treatment modality significantly associated with a longer progression-free survival. Additional studies with more cases and multi-institutional cooperation are needed to determine which treatment modality leads to better outcomes.

Keyword

Brain; Metastasis; Gynecology

MeSH Terms

Brain*
Disease-Free Survival
Early Diagnosis
Follow-Up Studies
Gynecology
Humans
Incidence
Medical Records
Neoplasm Metastasis*
Ovarian Neoplasms
Prognosis
Retrospective Studies*
Uterine Neoplasms

Figure

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  Fig. 1 The OS and PFS curve of patients with brain metastasis patients from all gynecologic cancers based on Kaplan-Meier survival estimates. OS, overall survival; PFS, progression-free survival.

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  Fig. 2 The OS and PFS curve of patients with brain metastasis from ovarian cancer based on Kaplan-Meier survival estimates. OS, overall survival; PFS, progression-free survival.

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  Fig. 3 A comparison of survival curves of patients with brain metastasis from all gynecologic cancers by treatment modalities. The green curve represents the patients who received surgical resection followed by WBRT and the blue curve represents the patients who received GKS as the primary treatment. WBRT, whole brain radiation therapy; GKS, Gamma Knife surgery; OP, operation.

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