Gynecologic cancer brain metastasis follows advanced illness and recurrence 2023

According to a study, patients with brain metastases from gynecologic malignancies frequently present with advanced disease and have experienced at least one prior recurrence. In addition, the extracranial disease is frequently present at the time of brain metastasis diagnosis.

Dr. Sadhvi Batra from the University Hospitals Cleveland Medical Center in Ohio, United States, recently presented these findings at the 2023 SGO Annual Meeting on Women’s Cancer.

Batra and colleagues conducted this single-center study to gain a better understanding of cerebral metastases in gynecologic cancers and to identify potential survival factors.

“Life-prolonging treatment options for brain metastases from gynecologic cancers have not been adequately described,” the researchers said. In addition, the unique molecular and genetic characteristics of brain metastases in gynecologic cancers are inadequately understood.

From 2001 to 2021, the research team gathered retrospective data on 65 patients with a primary diagnosis of gynecologic cancer who developed cerebral metastasis. They also conducted a survival analysis using the Kaplan-Meier method and the log-rank test to compare differences.

49% of the patients were diagnosed with uterine cancer, 34% with ovarian cancer, and 17% with cervical cancer. The majority of these patients presented with advanced disease, regardless of the form of cancer they had (p=0.34).

The median time for brain metastasis development was 19 months for uterine cancer patients, 36 months for ovarian cancer patients, and 22 months for cervical cancer patients. Prior to diagnosis, 33.8%, 38.4%, and 27.7% of these patients had experienced a first, second, and third recurrence, respectively.

In terms of overall survival, the median was 3 months for uterine cancer patients, 5 months for ovarian cancer patients, and 2 months for cervical cancer patients.

Multimodal treatment

“Although brain metastasis from gynecologic cancers is a rare occurrence in general, there has been a notable increase at our hospitals’ inpatient services in recent years,” the researchers said. “This may be attributed to advances in therapies for gynecologic malignancies that have resulted in longer survival, as well as advances in radiologic imaging that have made it easier for clinicians to diagnose brain metastasis.”

According to a 2016 study, the propensity of different types of tumors to metastasize differs, while the propensity to develop brain metastasis depends on disease stage, grade, and histology, as well as the genetic profile of the primary tumours.

In addition, the researchers of the aforementioned study recommended multimodal treatment for improved outcomes in the management of gynecologic cancer brain metastases.

“Given the poor survival of patients with brain metastasis and gynecologic cancers, future research should ultimately aim to improve life-prolonging interventions for this patient population,” stated the study’s researchers.

“Further understanding of the molecular and genetic alterations present in these patients has the potential to identify targets for early diagnosis and effective treatments,” the researchers noted.