Brain Metastases in Patients with Gynecologic Cancers: A Single Institution Experience and Review of the Literature

Open J Obstet Gynecol. 2016 Aug;6(9):544-552. doi: 10.4236/ojog.2016.69070. Epub 2016 Aug 15.

Abstract

Objective: Brain Metastasis (BM) from primary gynecologic cancers is a rare entity. The advances and successes in the treatment of primary gynecologic malignancies, have led to prolonged survival and, a higher incidence of BM. This study aims to report the experience at our institution in managing these patients, and provide possible data points that may be essential to note as prognostic factors, and see if our findings are consistent with the literature in this subject. We also aim to provide a brief literature review of patients with gynecologic cancers and BM.

Methods: This is a small single institution retrospective study of 23 patients with a gynecologic malignancy and BM, identified between the years 2007-2015. Data were collected on variables including patient demographics, disease and treatment.

Results: The median overall survival from the primary diagnosis was 28 months. Median time from diagnosis of BM to death was 9 months.

Conclusion: The outcomes in our study are similar to what is stated in the current literature with regard to BM from gynecologic malignancies. Our literature search also revealed that the molecular analysis and treatment of the primary tumor remain important to prevent BMs. The tendency of tumors to metastasize varies for one tumor type to another for the same type of tumor. The tendency to develop BM may not only depend on risk factors such as stage, grade, and histology, but also on the genetic profile of the primary tumor. The study suggests that multimodal treatment of BM has better outcomes in managing BM from gynecologic cancers.

Keywords: Brain Metastasis; Gynecologic Malignancies; Multimodality Therapy; Prognostic Factors.