Objective:
The objective of this study was to investigate the prevalence, clinicopathologic characteristics, management, and outcomes of patients with brain metastasis (BM) from gynecologic malignancies in a large hospital-based database.
Materials and Methods:
The National Cancer Database (NCDB) was accessed and patients with ovarian, uterine, or cervical cancer and BM were identified. We identified those who received radiation therapy (RT) as whole-brain radiation therapy (WBRT) or stereotactic radiosurgery (SRS). Kaplan-Meier curves were generated to determine median overall survival (OS) and compared with the log-rank test.
Results:
A total of 853 patients with BM were identified. The rate of BMs upon diagnosis was 0.4% (211/57,160) for patients with cervical cancer, 0.2% (498/243,785) for patients with uterine, and 0.2% (144/92,301) for ovarian malignancies. Only 30.4% had isolated BM, while 52.2% had lung metastasis. Approximately half of the patients (50.1%) received chemotherapy, while brain RT was administered to 324 (38%) patients. Among patients who received brain RT, only 60 (18.5%) had SRS, while 264 (81.5%) had WBRT. Patients who underwent SRS had a better survival (n=47, median OS=9 mo) than those who received WBRT (n=201, median OS=4.73 mo, P=0.018), or those who did not receive any brain RT (n=370, median OS=4.01 mo, P=0.007).
Conclusions:
The incidence of BM among patients with gynecologic malignancies is rare and associated with poor survival. For select patients, SRS may be associated with prolonged survival.
The authors declare no conflicts of interest.
Reprints: Dimitrios Nasioudis, MD, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hospital of the University of Pennsylvania, Helen O. Dickens Center for Women’s Health, 3400 Spruce Street, 1 West Gates, Philadelphia, PA 19104. E-mails: dimitrios.nasioudis@uphs.upenn.edu; dnasioudis@gmail.com.
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