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Abstract
Introduction/Background Metastases of epithelial ovarian cancer (OC) can involve the central nervous system (CNS), with an incidence of 1–2%. A fundamental prognostic factor for OC is the BReast CAncer genes (BRCA) mutation but there is inconsistency in literature exploring the correlations between BRCA status and BM.
Methodology Clinical and survival information of OC patients treated for BM in our Institute from 2000–2021 was retrospectively collected. Data were compared according to the BRCA status.
Results Among 94 patients, the BRCA status was known for 66, with 21 pathogenetic mutations (BRCAm, BRCA 1 and BRCA 2) and 45 wild-type genes (BRCAwt).BRCAm patients were younger when OC and BM were detected, and no differences in the time-interval between the two diagnoses were detected according to the BRCA status. Overall, patients appeared homogeneously distributed between the two groups regarding characteristics at primary diagnosis of OC and BM (table 1). More frequently, the histotype was the high-grade serous (86.2%), with FIGO stage III at disease presentation (78.7%). In most cases, CNS lesions were multiple and were associated with other extracranial metastatic sites in 59 cases (29 BRCAwt vs 14 BRCAm; P 0.544). The overall survival (OS) from the diagnosis of OC was better in BRCAm group rather than BRCAwt (median OS 81 months vs 39 months; P 0.017). Similarly, from the diagnosis of BM, the survival was longer in BRCAm patients (median OS 23 months vs 11 months; P 0.033). (figure 1)
Overall survival from OC and BM diagnosis according to the BRCA status
Characteristic of patients with BM according to the BRCA status
Conclusion No differences in clinical characteristics of patients at the diagnosis of OC and BM were found according to the BRCA status. A prolonged survival was detected in BRCAm vs BRCAwt OC patients with BM.