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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
  1. Gregory M. Gressel, MD,
  2. Lisbet S. Lundsberg, PhD,
  3. Gary Altwerger, MD,
  4. Tasleem Katchi, MD,
  5. Masoud Azodi, MD,
  6. Peter E. Schwartz, MD and
  7. Elena S. Ratner, MD
  1. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven CT.
  1. Address correspondence and reprint requests to Gregory M. Gressel, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, PO Box 208063, New Haven, CT 06520–8063. E-mail: gregory.gressel{at}gmail.com.

Abstract

Objective The reported incidence of brain metastasis from epithelial ovarian cancer (EOC), endometrial cancer (EC), and cervical cancer (CC) is exceedingly rare. As the long-term survival for patients with gynecologic cancer increases, there has been a corresponding increase in the number of diagnosed intracranial metastases. We seek to report our experience with managing brain metastatic disease (BMD) in patients with gynecologic cancer.

Methods A retrospective review of all patients with EOC, EC, and CC at our institution revealed 47 patients with concurrent BMD between 2000 and 2013. Demographic data, risk factors, treatment modalities, progression-free data, and overall survival data were collected.

Results Median survival time in patients with brain metastasis from EOC, EC, and CC was 9.0, 4.5, and 3.0 months, respectively. Two-year overall survival rates were 31.6%, 13.6%, and 0%, respectively. Patients received surgery, radiation therapy alone, palliative care, or radiation plus surgery. Radiation combined with surgical resection resulted in a significant hazards ratio of 0.36 (95% confidence interval, 0.15–0.86), compared with radiation alone.

Conclusions Our report provides a large single-institution experience of brain metastases from gynecologic cancer. Patients with BMD have poor prognoses; however, treatment with multimodal therapy including surgical resection and radiation may prolong overall survival.

  • Gynecologic cancer
  • Ovarian cancer
  • Endometrial cancer
  • Cervical cancer
  • Brain metastasis

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Footnotes

  • Dr Ratner is supported by K12 NIH grant.

  • The authors declare no conflicts of interest.

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