Solitary cerebral metastases from ovarian epithelial carcinoma: 11 cases

Abstract

Ovarian cancer is quite common in women, but brain metastases from ovarian cancer are considered rare. Eleven patients with solitary cerebral metastasis from ovarian epithelial carcinoma were treated at the Neurosurgical Department of University of Rome La Sapienza, between 1980 and 2000. We treated all of the 11 patients by surgical en bloc removal and by postoperative radiotherapy and chemotherapy. Mean survival was 28 months, and the cause of death was recurrence of the systemic disease in all cases. Multimodal treatment by surgery, radiation and chemotherapy is the best choice of treatment and leads to a median survival of about 20 months.

Prognostic factors for patients with brain metastasis from gynecological cancer: a significance of treatment-free interval of more than 6 months

“…In a nutshell, the ways of sampling in these studies might have been inappropriate for determining an accurate median survival period. Indeed, some studies with the long median survival focused on a particular group, for example, patients with solitary brain metastasis or patients who underwent craniotomy (23)(24)(25). According to the results of the largest study, the median survival periods after diagnosis of brain metastases were less than 12 months in every cancer category, namely lung cancer, breast cancer, renal cancer, malignant melanoma, gastrointestinal tract cancer, and 'other' cancer category (12).…”

Central Nervous System Involvement from Epithelial Ovarian Cancer

“…Although older studies suggested that these patients should undergone only palliative management, in the last 15 year's published studies many authors agree that a multi-modal treatment is the modality of choice in selected patients and can achieve a long-term remission and a better quality of life. (Anupol, 2002;Brown III, 2005;Chen, 2009;Cohen, 2004;Cormio, 1995;Cormio, 2003b;Cormio, 2011a;D'Andrea, 2005;Kastritis, 2006;Kim, 2007;Lee, 2008;Sanderson, 2002;Sehouli, 2010;Tay & Rajesh, 2005). An aggressive multimodal approach should be aimed both to cure local and systemic disease and leads to an improvement in duration and quality of life.…”

“…(Anupol, 2002;Brown III, 2005;Chen, 2009;Cohen, 2004;Cormio, 1995, 2003b, Cormio, 2011aD'Andrea, 2005;Kastritis, 2006;Kim, 2007;Kumar, 2003;Lee, 2008;Sanderson, 2002;Sehouli, 2010;Tay & Rajesh, 2005). However Kolomainen et al demonstrated in their series that a brain involvement could be seen quite frequently (one third of their patients) also in patients with FIGO stage I.…”

“…Other symptoms that are often described are vomiting, confusions, visual disturbances, paresis, and weakness, loss of consciousness, seizures, and dizziness. (Cohen, 2004;Cormio, 2011a;D'Andrea, 2005;Lee, 2008;Pectasides, 2006;Tay &Rajesh, 2005) The leptomeningeal involvement usually causes an arise of the intracranial pressure associated with hydrocephalus; these patients more frequently than the others complain also for bowel of bladder dysfunctions, while the involvement of cranial nerves can also be possible. (Pectasides, 2006;Vitaliani R, 2009) In our recent series of 20 patients, all patients were symptomatic at the moment of the diagnosis; most of them complain of headache, vomiting and dizziness with or without balance disturbances, less frequent symptoms were diplopia, convulsions, amnesia, confusion and pain.…”

“…In fact, while in 1995 the therapy was given more with palliative intent, nowadays clinicians are more likely to administer more aggressive and multimodal treatments, with the intent of both improving the quality of life and the overall survival. (Anupol, 2002;Brown III, 2005;Chen, 2009;Cohen, 2004;Cormio, 1995;Cormio, 2003b;Cormio, 2011a;D'Andrea, 2005;Kastritis, 2006;Kim, 2007;Lee, 2008;Sanderson, 2002;Sehouli, 2010;Tay & Rajesh, 2005) Future efforts can be put on one side, on the improvement of early diagnosis by the investigation of the role of new imaging techniques such as positron emission tomography and magnetic resonance spectroscopy in the detection of brain metastases, and on the other side on the improvement of treatment modality with higher efficacy and lower morbidity like the new radio surgical techniques. Although many authors agree that a multimodal approach results in better prognosis, further studies should be done to fix some guidelines for the treatment of these patients.…”