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Prognostic factors for brain metastasis in women presenting cervical cancer

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Abstract

Purpose

Although rare, brain metastases (BM) from cervical cancer (CC) are highly lethal. Adequate patient selection for specific treatments can improve survival rates in patients afflicted by this condition. This study aimed to describe the characteristics of CC patients who developed BM and overall survival-associated factors. Brain metastasis impact on the overall survival was assessed as a secondary objective.

Methods

This assessment comprises a retrospective cohort study on 3394 women presenting CC diagnosed between January 2010 and December 2017 at a single referral center. Incident BM cases were included. Descriptive statistics were calculated. Kaplan–Meier curves were used for the survival analysis and a Cox proportional hazards regression model was applied to explore the risk of death according to the analyzed independent variables.

Results

A total of 48 incident BM cases were identified. The median time between CC diagnosis and BM development was 1.5 years. Headaches (29.2%), dizziness/altered balance (29.2%), vertigo (29.2%) and motor disturbances (25.0%) were the most common signs and symptoms at presentation. Median overall survival after BM diagnosis was of 1.6 months (95% CI 0.9–2.3) while in the group of women without BM it was 5.5 years (95% CI 4.9–6.1). Concerning the Cox multivariate analysis, presenting one extracerebral metastases site (HR 2.8; 95% CI 1.3–6.2; p = 0.009) and receiving supportive treatment (HR 13.7; 95% CI 3.1–60.5; p 0.001) were independently associated with the risk of death.

Conclusion

The median survival of women with BM following CC was poor. Women without extracerebral metastases and undergoing multimodal treatment displayed better overall survival rates.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, Brazil

    Juliana de Brito Rangel, Alessandra Grasso Giglio & Luiz Claudio Santos Thuler

  2. Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil

    Juliana de Brito Rangel, Alessandra Grasso Giglio, Cristiane Lemos Cardozo, Anke Bergmann & Luiz Claudio Santos Thuler

  3. Brazilian National Cancer Institute (INCA), Coordenação de Pesquisa Clínica - Rua André Cavalcanti, 37 / Anexo - 3o andar–Centro, Rio de Janeiro, RJ, Postal Code: 20231-050, Brazil

    Luiz Claudio Santos Thuler

Authors
  1. Juliana de Brito Rangel
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  2. Alessandra Grasso Giglio
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  3. Cristiane Lemos Cardozo
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  4. Anke Bergmann
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  5. Luiz Claudio Santos Thuler
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Contributions

JBR, LCST: Study conception and design, JBR, AGG, CLC: Acquisition of data, LCST, AB: Supervision, CLC, JBR: Analysis and interpretation of imaging exams, JBR, LCST, AB: Analysis and interpretation of data, JBR, LCST: Drafting of manuscript, All authors: Critical revision.

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Correspondence to Luiz Claudio Santos Thuler.

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de Brito Rangel, J., Giglio, A.G., Cardozo, C.L. et al. Prognostic factors for brain metastasis in women presenting cervical cancer. J Neurooncol 159, 469–477 (2022). https://doi.org/10.1007/s11060-022-04082-9

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  • DOI: https://doi.org/10.1007/s11060-022-04082-9

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