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Brain metastases in patients with ovarian
carcinoma: prognostic factors and outcome
Cohen ZR, Suki D, Weinberg JS, Marmor E, Lang FF, Gershenson DM, Sawaya R
Department of Neurosurgery, Chaim Sheba Medical Center, Tel
Ashomer and Sackler School of Medicine, Tel Aviv, Israel.
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.
PMID: 15015663 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15015663
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