Abstract
To review the existing literature on brain metastasis (BM) from ovarian cancer and to assess the frequency, anatomical, clinical and paraclinical information and factors associated with prognosis. Ovarian cancer is a rare cause of brain metastasis with a recently reported increasing prevalence. Progressive neurologic disability and poor prognosis is common. A comprehensive review on this subject has not been published previously. This systematic literature search used the Pubmed and Yale library. A total of 66 publications were found, 57 of which were used representing 591 patients with BM from ovarian cancer. The median age of the patients was 54.3 years (range 20-81). A majority of patients (57.3 %) had multiple brain lesions. The location of the lesion was cerebellar (30 %), frontal (20 %), parietal (18 %) and occipital (11 %). Extracranial metastasis was present in 49.8 % of cases involving liver (20.7 %), lung (20.4 %), lymph nodes (12.6 %), bones (6.6 %) and pelvic organs (4.3 %). The most common symptoms were weakness (16 %), seizures (11 %), altered mentality (11 %) visual disturbances (9 %) and dizziness (8 %). The interval from diagnosis of breast cancer to BM ranged from 0 to 133 months (median 24 months) and median survival was 8.2 months. Local radiation, surgical resection, stereotactic radiosurgery and medical therapy were used. Factors that significantly increased the survival were younger age at the time of ovarian cancer diagnosis and brain metastasis diagnosis, lower grade of the primary tumor, higher KPS score and multimodality treatment for the brain metastases. Ovarian cancer is a rare cause of brain metastasis. Development of brain metastasis among older patients and lower KPS score correlate with less favorable prognosis. The more prolonged survival after using multimodality treatment for brain metastasis is important due to potential impact on management of brain metastasis in future.
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References
Wong J, Hird A, Kirou-Mauro A, Napolskikh J, Chow E (2008) Quality of life in brain metastases radiation trials: a literature review. Curr Oncol 15:25–45
Pietzner K, Oskay-Oezcelik G, El Khalfaoui K, Boehmer D, Lichtenegger W, Sehouli J (2009) Brain metastases from epithelial ovarian cancer: overview and optimal management. Anticancer Res 29:2793–2798
Hu XQ, Imitola J, Kim Y, Mahta A, Kesari S (2012) Brain metastasis from ovarian cancer: case report and review of the literature. Med Oncol 29:1250–1252
Chen YL, Cheng WF, Hsieh CY, Chen CA (2011) Brain metastasis as a late manifestation of ovarian carcinoma. Eur J Cancer Care (Engl) 20:44–49
Larson DM, Copeland LJ, Moser RP, Malone JM Jr, Gershenson DM, Wharton JT (1986) Central nervous system metastases in epithelial ovarian carcinoma. Obstet Gynecol 68:746–750
Cohen ZR, Suki D, Weinberg JS, Marmor E, Lang FF, Gershenson DM et al (2004) Brain metastases in patients with ovarian carcinoma: prognostic factors and outcome. J Neurooncol 66:313–325
D’Andrea G, Roperto R, Dinia L, Caroli E, Salvati M, Ferrante L (2005) Solitary cerebral metastases from ovarian epithelial carcinoma: 11 cases. Neurosurg Rev 28:120–123
Kaminsky-Forrett MC, Weber B, Conroy T, Spaeth D (2000) Brain metastases from epithelial ovarian carcinoma. Int J Gynecol Cancer 10:366–371
Pectasides D, Aravantinos G, Fountzilas G, Kalofonos C, Efstathiou E, Karina M et al (2005) Brain metastases from epithelial ovarian cancer. The Hellenic Cooperative Oncology Group (HeCOG) experience and review of the literature. Anticancer Res 25:3553–3558
Bruzzone M, Campora E, Chiara S, Giudici S, Merlini L, Simoni C et al (1993) Cerebral metastases secondary to ovarian cancer: still an unusual event. Gynecol Oncol 49:37–40
Ricke J, Baum K, Hosten N (1996) Calcified brain metastases from ovarian carcinoma. Neuroradiology 38:460–461
Sekine M, Yoshihara K, Komata D, Haino K, Nishino K, Tanaka K (2013) Increased incidence of brain metastases in BRCA1-related ovarian cancers. J Obstet Gynaecol Res 39:292–296
Patchell RA (2003) The management of brain metastases. Cancer Treat Rev 29:533–540
Ewend MG, Carey LA, Morris DE, Harvey RD, Hensing TA (2001) Brain metastases. Curr Treat Options Oncol 2:537–547
Growdon WB, Lopez-Varela E, Littell R, Oliva E, Seiden M, Krasner C et al (2008) Extent of extracranial disease is a powerful predictor of survival in patients with brain metastases from gynecological cancer. Int J Gynecol Cancer 18:262–268
Choo BA, Walji N, Spooner D, Barber P, Fernando IN (2010) Prolonged relapse-free survival in two patients with an isolated brain metastasis from epithelial ovarian carcinoma. J Clin Oncol 28:271–272
Melichar B, Urminská H, Kohlová T, Nová M, Cesák T (2004) Brain metastases of epithelial ovarian carcinoma responding to cisplatin and gemcitabine combination chemotherapy: a case report and review of the literature. Gynecol Oncol 94:267–276
McMeekin DS, Kamelle SA, Vasilev SA, Tillmanns TD, Gould NS, Scribner DR et al (2001) Ovarian cancer metastatic to the brain: what is the optimal management? J Surg Oncol 78:194–201
Root K, Armaghany T (2012) Solitary brain metastasis in a patient with ovarian cancer with BRCA2 mutation. J Clin Oncol 30(25):e239–e240
Piura E, Piura B (2011) Brain metastases from ovarian carcinoma. ISRN Oncol 2011:527453
Lee YK, Park NH, Kim JW, Song YS, Kang SB, Lee HP (2008) Gamma-knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer. Gynecol Oncol 108:505–509
Matsuo K, Eno ML, Ahn EH, Shahzad MM, Im DD, Rosenshein NB et al (2011) Multi-drug resistance gene (MDR-1) and risk of brain metastasis in epithelial ovarian, fallopian tube, and peritoneal cancer. Am J Clin Oncol 34:488–493
Cormio G, Loizzi V, Falagario M, Lissoni AA, Resta L, Selvaggi LE (2011) Changes in the management and outcome of central nervous system involvement from ovarian cancer since 1994. Int J Gynaecol Obstet 114:133–136
Clark TG, Stewart ME, Altman DG, Gabra H, Smyth JF (2001) A prognostic model for ovarian cancer. Br J Cancer 85:944–952
Anupol N, Ghamande S, Odunsi K, Driscoll D, Lele S (2002) Evaluation of prognostic factors and treatment modalities in ovarian cancer patients with brain metastases. Gynecol Oncol 85:487–492
Sehouli J, Pietzner K, Harter P, Munstedt K, Mahner S, Hasenburg A et al (2010) Prognostic role of platinum sensitivity in patients with brain metastases from ovarian cancer: results of a German multicenter study. Ann Oncol 21:2201–2205
Rostami R, Safarpour D, Tavassoli FA, Jabbari B (2013) Intramedullary metastasis in breast cancer—a comprehensive literature review. J Neurol Sci 332:16–20
Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P et al (2003) Distant metastases in ovarian carcinoma. Int J Gynecol Cancer 13:125–129
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Pakneshan, S., Safarpour, D., Tavassoli, F. et al. Brain metastasis from ovarian cancer: a systematic review. J Neurooncol 119, 1–6 (2014). https://doi.org/10.1007/s11060-014-1447-9
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DOI: https://doi.org/10.1007/s11060-014-1447-9