Treatment Results and Prognostic Factors of Brain Metastases From Ovarian Cancer: A Single Institutional Experience of 56 Patients

Kwon, Ji Woong; Yoon, Joon; Lim, Myong Cheol; Joo, Jungnam; Yoo, Heon; Shin, Sang Hoon; Park, Soo‐Jin; Lee, Sang Hyeon; Kim, Yeon Joo; Kim, Joo Young; Gwak, Ho Shin

doi:10.1097/igc.0000000000001341

Cited by 13 publications

(14 citation statements)

References 27 publications

(21 reference statements)

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“…This is a limit because macroscopic residual tumor after surgery is an independent prognostic factor in ovarian cancer [31], although it is unlikely to impact specifically on the development of brain metastases. Fourth, nearly all patients in our study have serous cancers, a good prognostic factor for patients with CNS involvement [11]. We could have selected a population with better prognosis, but in any case it appears to be well balanced to the control group as regards histology (see Table 5).…”

Section: Discussionmentioning

confidence: 99%

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Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Mittica¹,

Goia

Gambino

et al. 2020

J Ovarian Res

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Background: Central nervous system (CNS) spreading from epithelial ovarian carcinoma (EOC) is an uncommon but increasing phenomenon. We previously reported in a small series of 11 patients a correlation between Androgen Receptor (AR) loss and localization to CNS. Aims of this study were: to confirm a predictive role of AR loss in an independent validation cohort; to evaluate if AR status impacts on EOC survival. Results: We collected an additional 29 cases and 19 controls as validation cohort. In this independent cohort at univariate analysis, cases exhibited lower expression of AR, considered both as continuous (p < 0.001) and as discrete variable (10% cutoff: p < 0.003; Immunoreactive score: p < 0.001). AR negative EOC showed an odds ratio (OR) = 8.33 for CNS dissemination compared with AR positive EOC. Kaplan-Meier curves of the combined dataset, combining data of new validation cohort with the previously published cohort, showed that AR < 10% significantly correlates with worse outcomes (p = 0.005 for Progression Free Survival (PFS) and p = 0.002 for brain PFS (bPFS) respectively). Comparison of AR expression between primary tissue and paired brain metastases in the combined dataset did not show any statistically significant difference. Conclusions: We confirmed AR loss as predictive role for CNS involvement from EOC in an independent cohort of cases and controls. Early assessment of AR status could improve clinical management and patients' prognosis.

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Section: Discussionmentioning

confidence: 99%

“…serous histology, older age at diagnosis [7][8][9][10] and nonsurgical treatment [11]. Median overall survival (OS) is about 5 months for women undergoing a single-modality treatment versus 22 months if a multimodal approach is pursued [10,11].…”

mentioning

confidence: 99%

Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Mittica¹,

Goia

Gambino

et al. 2020

J Ovarian Res

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show abstract

“…This is a limit because macroscopic residual tumor after surgery is an independent prognostic factor in ovarian cancer (32), although it is unlikely to impact specifically on the development of brain metastases. Forth, nearly all patients in our study have serous cancers, a good prognostic factor for patients with CNS involvement (11). We could have selected a population with better prognosis, but in any case it appears to be well balanced to the control group as regards histology (see Table 5)…”

Section: Discussionmentioning

confidence: 99%

“…Recently, brain involvement seems to increase (6), probably due to improvement of medical treatments, radiotherapy and surgery (3,(7)(8)(9)(10). Negative prognostic factors in patients with CNS involvement are extra-cranial disease, single-treatment approach, multiple brain lesions, low Karnofsky Performance Status, non-serous histology, older age at diagnosis(7-10) and non-surgical treatment (11). Median overall survival (OS) is about 5 months for women undergoing a single-modality treatment versus 22 months if a multimodal approach is pursued (10,11).…”

Section: Introductionmentioning

confidence: 99%

Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Mittica¹,

Goia

Gambino

et al. 2020

Preprint

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Background Central nervous system (CNS) spreading from epithelial ovarian carcinoma (EOC) is an uncommon but increasing phenomenon. We previously reported in a small series of 11 patients a correlation between Androgen Receptor (AR) loss and localization to CNS. Aims of this study were: to confirm a predictive role of AR loss in an independent validation cohort; to evaluate if AR status impacts on EOC survival. Results We collected an additional 29 cases and 19 controls as validation cohort. In this independent cohort at univariate analysis, cases exhibited lower expression of AR, considered both as continuous (p<0.001) and as discrete variable (10% cut-off: p<0.003; Immunoreactive score: p<0.001). AR negative EOC showed an odds ratio (OR) = 8.33 for CNS dissemination compared with AR positive EOC. Kaplan-Meier curves of the combined dataset, combining data of new validation cohort with the previously published cohort, showed that AR<10% significantly correlates with worse outcomes (p=0.005 for Progression Free Survival (PFS) and p=0.002 for brain PFS (bPFS) respectively). Comparison of AR expression between primary tissue and paired brain metastases in the combined dataset did not show any statistically significant difference. Conclusions We confirmed AR loss as predictive role for CNS involvement from EOC in an independent cohort of cases and controls. Early assessment of AR status could improve clinical management and patients’ prognosis.

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“…Reports on surgical treatment for distant metastasis from ovarian cancer are limited. Kwon et al [ 6 ] reported that surgical resection for single or symptomatic brain metastasis from ovarian cancer prolonged survival. Burton et al [ 7 ] reported the outcomes of 20 cases of surgical treatment for recurrent ovarian cancer, including 11 patients with hepatic metastasis and 1 patient with pulmonary metastasis, and the 5-year overall survival rate was 45%.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of surgical resection for pulmonary metastasis from ovarian cancer

Kanzaki

Okami

Takami

et al. 2020

J Cardiothorac Surg

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Background Due to its rarity, information on pulmonary metastasectomy for pulmonary metastasis from ovarian cancer is limited. Methods Cases of pulmonary metastasectomy for ovarian cancer were collected in a multi-institutional setting and the outcomes were analyzed. Results Among 1508 cases in which pulmonary resection was performed to treat pulmonary metastasis from tumors of various organs, 6 cases (0.4%) involved pulmonary metastasis from ovarian cancer. The mean age was 61 years (range, 39–75 years). The histological types were undifferentiated carcinoma in 2 patients, and clear cell adenocarcinoma, serous papillary cystadenocarcinoma, serous adenocarcinoma, and endometroid adenocarcinoma in 1 patient each. One patient (17%) had a history of liver metastasis at the time of pulmonary resection. The median disease-free interval was 22 months (range, 0 [synchronous]-188 months). The tumor was solitary in 5 patients (83%). The mean tumor size was 15 mm (range, 5–23 mm). All 6 patients underwent complete resection. The type of resection was wide wedge resection in 3 patients, segmentectomy in 2 patients, and lobectomy in 1 patient. Four patients (67%) received postoperative chemotherapy. Thus far, 4 patients (67%) have experienced recurrence after pulmonary resection. In terms of outcomes, 1 patient who had synchronous pulmonary metastasis with the primary tumor died in the early period after pulmonary resection, 1 patient is alive without recurrence after a short follow-up period (5 months), 3 patients have achieved mid- to long-term survival and are alive with disease (38–61 months), and 1 patient achieved long-term (61 months) disease-free survival. Conclusions Patients with pulmonary metastasis from ovarian cancer who fulfill the eligibility criteria for pulmonary metastasectomy are rare. Pulmonary metastasectomy for ovarian cancer can provide favorable outcomes in highly selected patients. Patients with synchronous pulmonary metastasis from ovarian cancer are not good candidates for pulmonary metastasectomy.

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Treatment Results and Prognostic Factors of Brain Metastases From Ovarian Cancer: A Single Institutional Experience of 56 Patients

Cited by 13 publications

References 27 publications

Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers

Outcomes of surgical resection for pulmonary metastasis from ovarian cancer

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