Research Article
BibTex RIS Cite

Beyin Metastazlı Jinekolojik Kökenli Malignitelerde Prognostik Faktörlerin Analizi

Year 2023, Volume: 23 Issue: 2, 1 - 8, 06.11.2023

Abstract

Amaç: Jinekolojik kökenli beyin metastazı tanısı alan hastaların demografik ve klinik özelliklerini değerlendirmeyi ve beyin metastazi tanısından sonra prognozu etkileyen faktörleri incelemeyi amaçladık.
Materyal ve Metod: Başkent Üniversitesi Jinekolojik Onkoloji Anabilim Dalı'nda 2008-2021 yılları arasında jinekolojik kanser nedeniyle takip edilen ve beyin metastazı tanısı alan 48 hasta retrospektif olarak değerlendirildi. Hastaların demografik, klinik ve patolojik özellikleri ile ilk tanı anından itibaren uygulanan tedavilerin jinekolojik kanserlere göre dağılımı tespit edildi. Beyin metastazı teşhisi konulduktan sonra medyan sağkalım süreleri istatistiksel olarak değerlendirildi. Tanı sonrası beyin metastazi sonrası sağkalımı etkileyen prognostik faktörler istatistiksel olarak analiz edildi.
Bulgular: Beyin metastazi teşhisi konulduktan sonra medyan sağkalım süresi 8 aydı. Over kanserinde 12 ay, endometrial kanserde 4 ay, rahim ağzı kanserinde 8 ay, vulva kanserinde 3 ay, rahim sarkomlarında 4 aydı. Univaryant analizde lezyon sayısı, lokalizasyonu, ekstrakraniyal metastaz durumu ve tedavi yöntemi beyin metastazi sonrası sağkalım ile ilişkili bulunurken, multivaryant analizde lezyon lokalizasyonu ve tedavi yöntemi prognozu etkileyen bağımsız değişkenler olarak bulundu.
Sonuç: Beyin metastazından sonra prognozun en iyi kombine tedavi sonrasında elde edildiği görüldü. Bununla birlikte, tek başına stereotaktik beyin radyoterapisi, tek başına tüm beyin radyoterapisi alan hastalara kıyasla daha iyi bir prognoza sahipti.

References

  • 1. Al-Shamy G, Sawaya R. Management of brain me- tastases: the indispensable role of surgery. Journal of neuro-oncology. 2009;92:275-82.
  • 2. Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Current oncology reports. 2012;14:48- 54.
  • 3. Kato MK, Tanase Y, Uno M, Ishikawa M, Kato T. Brain metastases from uterine cervical and endometrial cancer. Cancers. 2021;13(3):519.
  • 4. Gien LT, Kwon JS, D'Souza DP, Radwan JS, Ham- mond JA, Sugimoto AK, et al. Brain metastases from endometrial carcinoma: a retrospective study. Gyne- cologic Oncology. 2004;93(2):524-8.
  • 5. Ogawa K, Yoshii Y, Aoki Y, Nagai Y, Tsuchida Y, Toita T, et al. Treatment and prognosis of brain metastases from gynecological cancers. Neurologia medico-chi- rurgica. 2008;48(2):57-63.
  • 6. Pakneshan S, Safarpour D, Tavassoli F, Jabbari B. Bra- in metastasis from ovarian cancer: a systematic revi- ew. Journal of neuro-oncology. 2014;119:1-6.
  • 7. Ratner ES, Toy E, O'Malley DM, Mcalpine J, Ruther- ford TJ, Azodi M, et al. Brain metastases in epithelial ovarian and primary peritoneal carcinoma. Interna- tional Journal of Gynecologic Cancer. 2009;19(5). :856-9
  • 8. Melone GA, D'Elia A, Brogna C, Salvati M. Uterine leiomyosarcoma metastatic to the brain: case report. Tumori Journal. 2008;94(6):856-60.
  • 9. Yamada S, Yamada SM, Nakaguchi H, Murakami M, Hoya K, Matsuno A. A case of multiple brain me- tastases of uterine leiomyosarcoma with a literature review. Surgical oncology. 2011;20(4):e127-e31. 10. Borella F, Bertero L, Morrone A, Gambella A, Bovet- ti M, Cosma S, et al. Brain metastases from ovarian cancer: current evidence in diagnosis, treatment, and prognosis. Cancers. 2020;12(8):2156.
  • 11. Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. The lancet oncology. 2009;10(11):1037-44.
  • 12. Monaco III E, Kondziolka D, Mongia S, Niran- jan A, Flickinger JC, Lunsford LD. Management of brain metastases from ovarian and endometrial carcinoma with stereotactic radiosurgery. Cancer. 2008;113(9):2610-4.
  • 13. Cormio G, Maneo A, Colamaria A, Loverro G, Lisso- ni A, Selvaggi L. Surgical resection of solitary brain metastasis from ovarian carcinoma: an analysis of 22 cases. Gynecologic oncology. 2003;89(1):116-9.
  • 14. Gressel GM, Lundsberg LS, Altwerger G, Katchi T, Azodi M, Schwartz PE, et al. Factors predictive of improved survival in patients with brain metastases from gynecologic cancer: a single institution retros- pective study of 47 cases and review of the litera- ture. International Journal of Gynecologic Cancer. 2015;25(9).
  • 15. Marchetti C, Ferrandina G, Cormio G, Gambino A, Cecere S, Lorusso D, et al. Brain metastases in pati- ents with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19). Gynecologic oncology. 2016;143(3):532-8.
  • 16. Uccella S, Morris JM, Multinu F, Cliby WA, Pod- ratz KC, Gostout BS, et al. Primary brain metas- tases of endometrial cancer: A report of 18 cases and review of the literature. Gynecologic oncology. 2016;142(1):70-5:141-6.
  • 17. Chura J, Shukla K, Argenta P. Brain metastasis from cervical carcinoma. International Journal of Gyneco- logic Cancer. 2007;17(1).
  • 18. Dursun P, Ayhan A, Tarhan NC, Coban G, Kuscu E. Cerebellar metastasis in squamous cell vulvar carcinoma. Archives of gynecology and obstetrics. 2009;279:69-71.
  • 19. Jaeger A, Biermann M, Prieske K, Grimm D, Grottke A, Salamon J, et al. Cerebral metastasis in recurrent squamous cell carcinoma of the vulva: case report and review of the literature. Archives of Gynecology and Obstetrics. 2020;301:327-32.
  • 20. Mahmoud-Ahmed AS, Suh JH, Barnett GH, Webster KD, Belinson JL, Kennedy AW. The effect of radiation therapy on brain metastases from endometrial carci- noma: a retrospective study. Gynecologic oncology. 2001;83(2):305-9. 8. Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases
  • 21. Lee Y-K, Park N-H, Kim JW, Song Y-S, Kang S-B, Lee H-P. Gamma-knife radiosurgery as an opti- mal treatment modality for brain metastases from epithelial ovarian cancer. Gynecologic oncology. 2008;108(3):505-9.
  • 22. Nasioudis D, Persaud A, Taunk NK, Latif NA. Brain metastases from gynecologic malignancies: preva- lence and management. American Journal of Clinical Oncology. 2020;43(6):418-21.
  • 23. Meixner E, Eichkorn T, Erdem S, König L, Lang K, Lischalk JW, et al. Stereotactic radiosurgery for brain metastases from pelvic gynecological malignancies: oncologic outcomes, validation of prognostic scores, and dosimetric evaluation. International Journal of Gynecologic Cancer. 2022;32(2):172-180.
  • 24. Deng K, Yang C, Tan Q, Song W, Lu M, Zhao W, et al. Sites of distant metastases and overall survival in ovarian cancer: a study of 1481 patients. Gynecolo- gic oncology. 2018;150(3):460-5.
  • 25. Ewend MG, Morris DE, Carey LA, Ladha AM, Brem S. Guidelines for the initial management of metasta- tic brain tumors: role of surgery, radiosurgery, and radiation therapy. Journal of the National Compre- hensive Cancer Network. 2008;6(5):505-14.
  • 26. Divine LM, Kizer NT, Hagemann AR, Pittman ME, Chen L, Powell MA, et al. Clinicopathologic charac- teristics and survival of patients with gynecologic malignancies metastatic to the brain. Gynecologic oncology. 2016;142(1):76-82.

Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases

Year 2023, Volume: 23 Issue: 2, 1 - 8, 06.11.2023

Abstract

Objective: We aimed to evaluate the demographic and clinical characteristics of patients diagnosed with brain metastases of gynecological origin and to analyze the factors affecting prognosis after the diagnosis of brain metastases.
Material and Methods: Forty-eight patients with brain metastases who were followed for gynecological cancer in Başkent University's Department of Gynecological Oncology between 2008 and 2021 were evaluated retrospectively. Demographic, clinical, and pathological characteristics of the patients and the distribution of treatments according to gynecological cancers since the time of primary diagnosis were noted. Median survival times after the diagnosis of brain metastasis were evaluated statistically. Prognostic factors affecting the process of brain metastasis and survival after diagnosis were statistically analyzed.
Results: The median survival time after the diagnosis of brain metastasis was 8 months. It was 12 months in cases of ovarian cancer, 4 months for endometrial cancer, 8 months for cervical cancer, 3 months for vulvar cancer, and 4 months for uterine sarcomas. In univariate analysis, lesion number, localization, extracranial metastasis status, and treatment method were found to be associated with survival after brain metastasis, while lesion localization and treatment method were independent variables affecting prognosis in multivariate analysis.
Conclusion: Patients with the best prognosis after brain metastasis were treated with combined therapy. However, stereotactic brain radiotherapy alone had a better prognosis compared to patients who received whole brain radiotherapy alone.

References

  • 1. Al-Shamy G, Sawaya R. Management of brain me- tastases: the indispensable role of surgery. Journal of neuro-oncology. 2009;92:275-82.
  • 2. Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Current oncology reports. 2012;14:48- 54.
  • 3. Kato MK, Tanase Y, Uno M, Ishikawa M, Kato T. Brain metastases from uterine cervical and endometrial cancer. Cancers. 2021;13(3):519.
  • 4. Gien LT, Kwon JS, D'Souza DP, Radwan JS, Ham- mond JA, Sugimoto AK, et al. Brain metastases from endometrial carcinoma: a retrospective study. Gyne- cologic Oncology. 2004;93(2):524-8.
  • 5. Ogawa K, Yoshii Y, Aoki Y, Nagai Y, Tsuchida Y, Toita T, et al. Treatment and prognosis of brain metastases from gynecological cancers. Neurologia medico-chi- rurgica. 2008;48(2):57-63.
  • 6. Pakneshan S, Safarpour D, Tavassoli F, Jabbari B. Bra- in metastasis from ovarian cancer: a systematic revi- ew. Journal of neuro-oncology. 2014;119:1-6.
  • 7. Ratner ES, Toy E, O'Malley DM, Mcalpine J, Ruther- ford TJ, Azodi M, et al. Brain metastases in epithelial ovarian and primary peritoneal carcinoma. Interna- tional Journal of Gynecologic Cancer. 2009;19(5). :856-9
  • 8. Melone GA, D'Elia A, Brogna C, Salvati M. Uterine leiomyosarcoma metastatic to the brain: case report. Tumori Journal. 2008;94(6):856-60.
  • 9. Yamada S, Yamada SM, Nakaguchi H, Murakami M, Hoya K, Matsuno A. A case of multiple brain me- tastases of uterine leiomyosarcoma with a literature review. Surgical oncology. 2011;20(4):e127-e31. 10. Borella F, Bertero L, Morrone A, Gambella A, Bovet- ti M, Cosma S, et al. Brain metastases from ovarian cancer: current evidence in diagnosis, treatment, and prognosis. Cancers. 2020;12(8):2156.
  • 11. Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. The lancet oncology. 2009;10(11):1037-44.
  • 12. Monaco III E, Kondziolka D, Mongia S, Niran- jan A, Flickinger JC, Lunsford LD. Management of brain metastases from ovarian and endometrial carcinoma with stereotactic radiosurgery. Cancer. 2008;113(9):2610-4.
  • 13. Cormio G, Maneo A, Colamaria A, Loverro G, Lisso- ni A, Selvaggi L. Surgical resection of solitary brain metastasis from ovarian carcinoma: an analysis of 22 cases. Gynecologic oncology. 2003;89(1):116-9.
  • 14. Gressel GM, Lundsberg LS, Altwerger G, Katchi T, Azodi M, Schwartz PE, et al. Factors predictive of improved survival in patients with brain metastases from gynecologic cancer: a single institution retros- pective study of 47 cases and review of the litera- ture. International Journal of Gynecologic Cancer. 2015;25(9).
  • 15. Marchetti C, Ferrandina G, Cormio G, Gambino A, Cecere S, Lorusso D, et al. Brain metastases in pati- ents with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19). Gynecologic oncology. 2016;143(3):532-8.
  • 16. Uccella S, Morris JM, Multinu F, Cliby WA, Pod- ratz KC, Gostout BS, et al. Primary brain metas- tases of endometrial cancer: A report of 18 cases and review of the literature. Gynecologic oncology. 2016;142(1):70-5:141-6.
  • 17. Chura J, Shukla K, Argenta P. Brain metastasis from cervical carcinoma. International Journal of Gyneco- logic Cancer. 2007;17(1).
  • 18. Dursun P, Ayhan A, Tarhan NC, Coban G, Kuscu E. Cerebellar metastasis in squamous cell vulvar carcinoma. Archives of gynecology and obstetrics. 2009;279:69-71.
  • 19. Jaeger A, Biermann M, Prieske K, Grimm D, Grottke A, Salamon J, et al. Cerebral metastasis in recurrent squamous cell carcinoma of the vulva: case report and review of the literature. Archives of Gynecology and Obstetrics. 2020;301:327-32.
  • 20. Mahmoud-Ahmed AS, Suh JH, Barnett GH, Webster KD, Belinson JL, Kennedy AW. The effect of radiation therapy on brain metastases from endometrial carci- noma: a retrospective study. Gynecologic oncology. 2001;83(2):305-9. 8. Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases
  • 21. Lee Y-K, Park N-H, Kim JW, Song Y-S, Kang S-B, Lee H-P. Gamma-knife radiosurgery as an opti- mal treatment modality for brain metastases from epithelial ovarian cancer. Gynecologic oncology. 2008;108(3):505-9.
  • 22. Nasioudis D, Persaud A, Taunk NK, Latif NA. Brain metastases from gynecologic malignancies: preva- lence and management. American Journal of Clinical Oncology. 2020;43(6):418-21.
  • 23. Meixner E, Eichkorn T, Erdem S, König L, Lang K, Lischalk JW, et al. Stereotactic radiosurgery for brain metastases from pelvic gynecological malignancies: oncologic outcomes, validation of prognostic scores, and dosimetric evaluation. International Journal of Gynecologic Cancer. 2022;32(2):172-180.
  • 24. Deng K, Yang C, Tan Q, Song W, Lu M, Zhao W, et al. Sites of distant metastases and overall survival in ovarian cancer: a study of 1481 patients. Gynecolo- gic oncology. 2018;150(3):460-5.
  • 25. Ewend MG, Morris DE, Carey LA, Ladha AM, Brem S. Guidelines for the initial management of metasta- tic brain tumors: role of surgery, radiosurgery, and radiation therapy. Journal of the National Compre- hensive Cancer Network. 2008;6(5):505-14.
  • 26. Divine LM, Kizer NT, Hagemann AR, Pittman ME, Chen L, Powell MA, et al. Clinicopathologic charac- teristics and survival of patients with gynecologic malignancies metastatic to the brain. Gynecologic oncology. 2016;142(1):76-82.
There are 25 citations in total.

Details

Primary Language English
Subjects Gynecologic Oncology Surgery
Journal Section Research Article
Authors

Tahir Eryılmaz

Hüseyin Akıllı

Ali Ayhan

Ahmet Muhteşem Ağıldere This is me

Early Pub Date November 6, 2023
Publication Date November 6, 2023
Submission Date June 20, 2023
Published in Issue Year 2023 Volume: 23 Issue: 2

Cite

APA Eryılmaz, T., Akıllı, H., Ayhan, A., Ağıldere, A. M. (2023). Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases. Türk Jinekolojik Onkoloji Dergisi, 23(2), 1-8.
AMA Eryılmaz T, Akıllı H, Ayhan A, Ağıldere AM. Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases. TRSGO Dergisi. November 2023;23(2):1-8.
Chicago Eryılmaz, Tahir, Hüseyin Akıllı, Ali Ayhan, and Ahmet Muhteşem Ağıldere. “Analysis of Prognostic Factors in Malignancies of Gynecological Origin With Brain Metastases”. Türk Jinekolojik Onkoloji Dergisi 23, no. 2 (November 2023): 1-8.
EndNote Eryılmaz T, Akıllı H, Ayhan A, Ağıldere AM (November 1, 2023) Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases. Türk Jinekolojik Onkoloji Dergisi 23 2 1–8.
IEEE T. Eryılmaz, H. Akıllı, A. Ayhan, and A. M. Ağıldere, “Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases”, TRSGO Dergisi, vol. 23, no. 2, pp. 1–8, 2023.
ISNAD Eryılmaz, Tahir et al. “Analysis of Prognostic Factors in Malignancies of Gynecological Origin With Brain Metastases”. Türk Jinekolojik Onkoloji Dergisi 23/2 (November 2023), 1-8.
JAMA Eryılmaz T, Akıllı H, Ayhan A, Ağıldere AM. Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases. TRSGO Dergisi. 2023;23:1–8.
MLA Eryılmaz, Tahir et al. “Analysis of Prognostic Factors in Malignancies of Gynecological Origin With Brain Metastases”. Türk Jinekolojik Onkoloji Dergisi, vol. 23, no. 2, 2023, pp. 1-8.
Vancouver Eryılmaz T, Akıllı H, Ayhan A, Ağıldere AM. Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases. TRSGO Dergisi. 2023;23(2):1-8.