Introduction/Background Central nervous system (CNS) metastasis originating from gynecological cancer is a 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.
Methodology 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. Gynecological cancers were divided into four groups according to their origin, including epithelial ovarian cancer, endometrial cancer, cervical cancer, and vulvar cancer. Treatment-free interval(TFI) was determined as the time from the last treatment of gynecologic cancer to the diagnosis of CNS metastasis.
Results 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). Median time from initial cancer diagnosis to CNS metastasis was 24.9 (range: 0 – 108.2) months. Most patients had epithelial ovarian cancer (76.6%), followed by endometrial cancer (14.8%), cervical cancer (4.3%), and vulvar cancer (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.
Conclusion Patients with CNS metastasis who have favorable prognostic factors are considered to be appropriate candidates for aggressive and long-term treatment strategy. 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.
Disclosures We declared that we have no conflict of interest
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