KEY TAKEAWAYS
- The study aimed to investigate the prognostic factors influencing survival in gynecological cancer patients with BM.
- Researchers noticed significant prognostic differences in patients with gynecological cancer with BM.
In this large population-based, retrospective, single-center study, Silje Skjelsvik Os and the team aimed to identify prognostic factors in patients with brain metastases (BM) originating from gynecological cancers.
They performed an inclusive analysis involving 144 patients diagnosed with BM from gynecological cancer who underwent radiotherapy (RT). Key variables including primary cancer diagnosis, age, performance status, number of BM, presence of extracranial disease, and type of BM treatment were meticulously assessed.
Overall survival (OS) was calculated using the Kaplan-Meier method, and multivariable analysis was conducted utilizing the Cox proportional hazards regression model. A prognostic index (PI) was then developed based on scores derived from independent predictors of OS, providing a comprehensive framework for prognostic evaluation in this patient population.
The median OS for the entire study population was 6.2 months, with 40% of patients succumbing within 3 months post-commencement of RT. Primary cancer originating from the cervix or vulva (P = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status of 3-4 (P < 0.001), and the presence of extracranial disease (P = 0.001) were all significantly associated with shorter OS.
The developed PI, incorporating these factors, stratified patients into three risk groups, with median OS of 13.5, 4.0, and 2.4 months for the good, intermediate, and poor prognosis groups, respectively.
The study concluded that patients with BM from gynecological cancers face a challenging prognosis. Through the identification of prognostic factors and the development of a scoring tool, stratification of patients into risk groups was achieved, highlighting the particularly poor prognosis of those in the high-risk category. Considering the observed prognostic differences, the omission of RT may be warranted for select high-risk patients, offering a tailored approach to treatment decision-making.
No funds information was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/38647023/
Os SS, Skipar K, Skovlund E, et al. (2024). “Survival prediction in patients with gynecological cancer irradiated for brain metastases.” Acta Oncol. 2024 Apr 21;63:206-212. doi: 10.2340/1651-226X.2023.34899. PMID: 38647023.