Age, pathology and CA-125 are prognostic factors for survival in patients with brain metastases from gynaecological tumours

• Main Authors: S.H.J. Nagtegaal, A.F.C. Hulsbergen, E.B.L. van Dorst, V.K. Kavouridis, C.A.C. Jessurun, M.L.D. Broekman, T.R. Smith, J.J.C. Verhoeff
• Format: Article
• Language: English
• Published: Elsevier 2020-09-01
• Series: Clinical and Translational Radiation Oncology
• Subjects: Brain metastasis; Gynaecological malignancies; Prognosis; Survival
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405630820300367

Background and purpose: Brain metastases originating from gynaecological tumours are a rare phenomenon, but have an increasing incidence due to better targeted therapies. This study aimed to identify factors that predict survival in these patients, which can be used in creating a robust prognostic tool for shared decision making. Materials and methods: We identified a consecutive cohort of 73 patients treated for gynaecological brain metastases in two tertiary institutions. Baseline demographics, pathology and serum CA-125 were included in a multivariable Cox proportional hazards model. Results: Median overall survival in our cohort was 14.4 months, with a one-year survival of 56.4% and a two-year survival of 39.1%. Thirty-eight patients (52.1%) had ovarian carcinoma as the primary malignancy. The following factors were significantly associated with survival: age (HR 1.05 per year), CA-125 (HR 1.02 par 50 U/ml), and uterine and vulvar primary tumours (when compared to ovarian carcinoma, with HRs 3.07 and 8.70). A post-hoc analysis with primary tumour site reclassified into ovary versus non-ovary showed a HR of 0.50 for ovarian primary tumour type. Conclusion: We have found that age, pathology and CA-125 are prognostic factors for survival in patients with brain metastases from gynaecological tumours. Our findings may provide a foundation for future development of prediction models, for the benefit of both patients and physicians.