Survival Impact of Optimal Surgical Cytoreduction in Recurrent Epithelial Ovarian Cancer with Brain Metastasis

Oncol Res Treat. 2019;42(3):101-106. doi: 10.1159/000494334. Epub 2019 Jan 19.

Abstract

Aim: The aim of this study was to determine the clinicopathological characteristics, treatment details and outcome of patients with brain metastasis from epithelial ovarian carcinoma (EOC).

Methods: This study included 21 patients diagnosed with brain metastasis from EOC between 1999 and 2009.

Results: Median age was 61 years (range 38-77). The median time elapsed from EOC diagnosis to brain metastasis detection was 32 months. Single brain metastases were found in 10 (48%) cases, and there was extra-cranial disease in 11 (52%) cases. During the mean 86 months of follow-up, 18 of the patients (86%) died of the disease and 3 (14%) were alive with disease. The median survival time after the initial diagnosis of brain metastasis was 9 months. The median overall survival (OS) from initial diagnosis of EOC was 50 months. In univariate analysis, prolonged time from initial diagnosis to central nervous system metastasis (more than 32 months) (p = 0.001), treatment with radiotherapy (p < 0.001), optimal cytoreductive operation (p = 0.02) were all positively correlated with OS.

Conclusion: The prognosis of patients with brain metastasis from EOC is still poor. The significant predictors of survival in our series were whole brain radiotherapy, prolonged elapsed time from initial diagnosis to brain metastasis and optimal cytoreductive surgery.

Keywords: Brain metastasis; Ovarian carcinoma; Prognostic factors; Survival.

MeSH terms

  • Adult
  • Aged
  • Brain / surgery
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy*
  • Carcinoma, Ovarian Epithelial / mortality
  • Carcinoma, Ovarian Epithelial / secondary
  • Carcinoma, Ovarian Epithelial / therapy*
  • Cytoreduction Surgical Procedures*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / secondary
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasm Staging
  • Ovarian Neoplasms / pathology*
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Treatment Outcome