Journal of Neuro-Oncology

, Volume 66, Issue 3, pp 313–325 | Cite as

Brain Metastases in Patients with Ovarian Carcinoma: Prognostic Factors and Outcome

  • Zvi R. Cohen
  • Dima Suki
  • Jeffrey S. Weinberg
  • Eric Marmor
  • Frederick F. Lang
  • David M. Gershenson
  • Raymond Sawaya
Article

Abstract

Between January 1975 and April 2001, 8,225 patients with ovarian cancer were seen at The University of Texas M. D. Anderson Cancer Center. Brain metastases developed in 72 of these patients (0.9%). The medical records of these patients were reviewed to assess the incidence of these metastases and their correlates of survival, as well as to describe the various treatment modalities used against them and their respective outcomes. The mean age of patients at the time of brain metastasis diagnosis was 53.7 years. The median interval between the diagnosis of the primary cancer and brain metastasis was 1.84 years. Neurological deficit, headache, and seizure were the most common symptoms. The brain was the only site of metastasis in 43% of patients. Multiple metastases were seen in 65% of them, although this may be a slight underestimate, as brain metastases in 17% of patients were evaluated prior to the magnetic resonance imaging era. The median survival time after the diagnosis of brain metastases was 6.27 months (95% CI, 4.48–8.06 months). The combination of surgical resection and whole-brain radiation therapy (WBRT) resulted in a longer survival time (median, 23.07 months) than did WBRT alone (median, 5.33 months) or surgery alone (median, 6.90 months) (p < 0.01 in both instances, multivariate Cox proportional hazards model analysis). The prognosis for patients with brain metastases from ovarian cancer appears to be poor. The existence of systemic dissemination at the time of brain metastasis was associated with a worse survival trend. The only significant predictor of survival in our series was the treatment modality. In particular, the resection of brain metastasis from ovarian cancer followed by WBRT appeared to be superior to resection alone or WBRT alone.

brain metastasis ovarian cancer 

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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Zvi R. Cohen
    • 1
  • Dima Suki
    • 2
  • Jeffrey S. Weinberg
    • 2
  • Eric Marmor
    • 4
  • Frederick F. Lang
    • 2
  • David M. Gershenson
    • 3
  • Raymond Sawaya
    • 1
  1. 1.Department of NeurosurgeryChaim Sheba Medical Center, Tel Ashomer and Sackler School of MedicineTel AvivIsrael
  2. 2.The Brain Tumor CenterThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  3. 3.Gynecologic OncologyThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  4. 4.Jewish General Hospital HampsteadCanada

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