[Clinical analysis of 23 gynecologic carcinoma patients with brain metastasis]

Zhonghua Yi Xue Za Zhi. 2016 Jun 21;96(23):1843-6. doi: 10.3760/cma.j.issn.0376-2491.2016.23.012.
[Article in Chinese]

Abstract

Objective: To explore the clinicopathological characteristics and treatments of brain metastasis (BM) in patients with gynecologic carcinoma.

Methods: Twenty-three pathologically confirmed patients with gynecologic carcinoma who had brain metastasis between February 2008 and October 2012 were analyzed retrospectively.

Results: The primary carcinoma was cervical cancer in 5 patients, endometrial carcinoma in 8 patients and ovarian cancer in 10 patients, which accounted for 1.81% (5/276), 2.10% (8/380) and 2.67% (10/374) of patient with the same diagnosis of the same period, respectively.Among them, 91.3% (21/23) patients had heterochronous BM.Single BM was documented in 52.2% (12/23) patients.Besides, 78.2% (18/23) BM located in cerebrum.At the time of BM, 91.3% (21/23) patients had symptoms of central nervous system, in which headache ranked the top (90.4%). Altogether, thirteen patients had extracranial metastasis, in which 9 of them had metastasis of the lung.The median post-brain-metastasis survival (mPBMS) for the recursive partitioning analysis (RPA) classes Ⅰ-Ⅲ was 54 months, 9 months and 1 month, respectively (P<0.01). None of surgery, radiotherapy or chemotherapy treatment was proven to have prognosis-improving ability either in single variant or multivariate analysis.However, in patients with extracranial metastasis, chemotherapy could significantly improve their mPBMS (P<0.05).

Conclusions: The incidence of brain metastasis in patients with cervical cancer, endometrial carcinoma, and ovarian cancer increased gradually.RPA was valuable for a prognostic assessment in gynecologic carcinoma patients with BM.Chemotherapy could significantly improve prognosis of gynecologic carcinoma patients with BM if extracranial metastasis was presented.

MeSH terms

  • Brain / pathology*
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / therapy*
  • Chemoradiotherapy
  • Female
  • Genital Neoplasms, Female / mortality*
  • Genital Neoplasms, Female / pathology
  • Genital Neoplasms, Female / therapy
  • Humans
  • Multivariate Analysis
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy
  • Uterine Neoplasms / mortality
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / therapy