Ovarian cancer metastatic to the brain

What is the optimal management?

D. Scott McMeekin, Scott A. Kamelle, Steve A. Vasilev, Todd Tillmanns, Natalie S. Gould, Dennis R. Scribner, Michael A. Gold, Suresh Guruswamy, Robert S. Mannel

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Purpose: To better define determinants of survival and optimal management strategies for patients with ovarain cancer and brain metastases. Methods: A review of literature using Medline identified 15 case series of ovarian cancer patients with brain metastases (OBM). Each article was abstracted for survival data, and in all cases, the intervals between ovarian cancer diagnosis and brain metastasis identification, and between brain metastasis identification and last follow-up were recorded. Cases were categorized by patient characteristics and treatment modality for brain metastases. Estimated survival probabilities were plotted using the Kaplan-Meier method with differences between subgroups analyzed by the log-rank test. Cox proportional hazards model was used to identify independent prognostic factors age, number of metastasis, and treatment modality associated with survival. Results: The median interval from ovarian cancer diagnosis to brain metastasis in 104 identified patients was 19.5 months. Brain metastasis was single in 43%, multiple in 41%, and not reported in 16% of cases. About 81.7% of patients were treated for their brain metastases using external radiation therapy (XRT), chemotherapy, and surgery. XRT was utilized in 76% of 104 patients and in 93% of treated patients. The most commonly used modalities were XRT alone (40%) and craniotomy and XRT (17%). The median survival (MS) for all patients regardless of treatment type was 6 months. Patients who received any treatment lived longer than those not receiving surgery/chemotherapy/XRT (MS; 7 months vs. 2 months, P=0.0001). Patients with single brain metastasis had a longer median survival (21 months vs. 6 months, P = 0.049) when treated with craniotomy plus radiation and/or chemotherapy compared to treatment regimens that excluded craniotomy. In a multivariate analysis, only treatment type was significant in predicting survival. Conclusion: OBM portends a poor prognosis, however, long-term survival is possible. Patients appear to benefit from therapy, especially selected groups of OBM patients with single brain metastasis treated with radiation therapy and surgery.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalJournal of Surgical Oncology
Volume78
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

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Ovarian Neoplasms
Neoplasm Metastasis
Brain
Survival
Craniotomy
Drug Therapy
Brain Neoplasms
Therapeutics
Radiotherapy
Proportional Hazards Models
Multivariate Analysis
Radiation

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Scott McMeekin, D., Kamelle, S. A., Vasilev, S. A., Tillmanns, T., Gould, N. S., Scribner, D. R., ... Mannel, R. S. (2001). Ovarian cancer metastatic to the brain: What is the optimal management? Journal of Surgical Oncology, 78(3), 194-200. https://doi.org/10.1002/jso.1149

Ovarian cancer metastatic to the brain : What is the optimal management? / Scott McMeekin, D.; Kamelle, Scott A.; Vasilev, Steve A.; Tillmanns, Todd; Gould, Natalie S.; Scribner, Dennis R.; Gold, Michael A.; Guruswamy, Suresh; Mannel, Robert S.

In: Journal of Surgical Oncology, Vol. 78, No. 3, 2001, p. 194-200.

Research output: Contribution to journalArticle

Scott McMeekin, D, Kamelle, SA, Vasilev, SA, Tillmanns, T, Gould, NS, Scribner, DR, Gold, MA, Guruswamy, S & Mannel, RS 2001, 'Ovarian cancer metastatic to the brain: What is the optimal management?', Journal of Surgical Oncology, vol. 78, no. 3, pp. 194-200. https://doi.org/10.1002/jso.1149
Scott McMeekin, D. ; Kamelle, Scott A. ; Vasilev, Steve A. ; Tillmanns, Todd ; Gould, Natalie S. ; Scribner, Dennis R. ; Gold, Michael A. ; Guruswamy, Suresh ; Mannel, Robert S. / Ovarian cancer metastatic to the brain : What is the optimal management?. In: Journal of Surgical Oncology. 2001 ; Vol. 78, No. 3. pp. 194-200.
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abstract = "Purpose: To better define determinants of survival and optimal management strategies for patients with ovarain cancer and brain metastases. Methods: A review of literature using Medline identified 15 case series of ovarian cancer patients with brain metastases (OBM). Each article was abstracted for survival data, and in all cases, the intervals between ovarian cancer diagnosis and brain metastasis identification, and between brain metastasis identification and last follow-up were recorded. Cases were categorized by patient characteristics and treatment modality for brain metastases. Estimated survival probabilities were plotted using the Kaplan-Meier method with differences between subgroups analyzed by the log-rank test. Cox proportional hazards model was used to identify independent prognostic factors age, number of metastasis, and treatment modality associated with survival. Results: The median interval from ovarian cancer diagnosis to brain metastasis in 104 identified patients was 19.5 months. Brain metastasis was single in 43{\%}, multiple in 41{\%}, and not reported in 16{\%} of cases. About 81.7{\%} of patients were treated for their brain metastases using external radiation therapy (XRT), chemotherapy, and surgery. XRT was utilized in 76{\%} of 104 patients and in 93{\%} of treated patients. The most commonly used modalities were XRT alone (40{\%}) and craniotomy and XRT (17{\%}). The median survival (MS) for all patients regardless of treatment type was 6 months. Patients who received any treatment lived longer than those not receiving surgery/chemotherapy/XRT (MS; 7 months vs. 2 months, P=0.0001). Patients with single brain metastasis had a longer median survival (21 months vs. 6 months, P = 0.049) when treated with craniotomy plus radiation and/or chemotherapy compared to treatment regimens that excluded craniotomy. In a multivariate analysis, only treatment type was significant in predicting survival. Conclusion: OBM portends a poor prognosis, however, long-term survival is possible. Patients appear to benefit from therapy, especially selected groups of OBM patients with single brain metastasis treated with radiation therapy and surgery.",
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T1 - Ovarian cancer metastatic to the brain

T2 - What is the optimal management?

AU - Scott McMeekin, D.

AU - Kamelle, Scott A.

AU - Vasilev, Steve A.

AU - Tillmanns, Todd

AU - Gould, Natalie S.

AU - Scribner, Dennis R.

AU - Gold, Michael A.

AU - Guruswamy, Suresh

AU - Mannel, Robert S.

PY - 2001

Y1 - 2001

N2 - Purpose: To better define determinants of survival and optimal management strategies for patients with ovarain cancer and brain metastases. Methods: A review of literature using Medline identified 15 case series of ovarian cancer patients with brain metastases (OBM). Each article was abstracted for survival data, and in all cases, the intervals between ovarian cancer diagnosis and brain metastasis identification, and between brain metastasis identification and last follow-up were recorded. Cases were categorized by patient characteristics and treatment modality for brain metastases. Estimated survival probabilities were plotted using the Kaplan-Meier method with differences between subgroups analyzed by the log-rank test. Cox proportional hazards model was used to identify independent prognostic factors age, number of metastasis, and treatment modality associated with survival. Results: The median interval from ovarian cancer diagnosis to brain metastasis in 104 identified patients was 19.5 months. Brain metastasis was single in 43%, multiple in 41%, and not reported in 16% of cases. About 81.7% of patients were treated for their brain metastases using external radiation therapy (XRT), chemotherapy, and surgery. XRT was utilized in 76% of 104 patients and in 93% of treated patients. The most commonly used modalities were XRT alone (40%) and craniotomy and XRT (17%). The median survival (MS) for all patients regardless of treatment type was 6 months. Patients who received any treatment lived longer than those not receiving surgery/chemotherapy/XRT (MS; 7 months vs. 2 months, P=0.0001). Patients with single brain metastasis had a longer median survival (21 months vs. 6 months, P = 0.049) when treated with craniotomy plus radiation and/or chemotherapy compared to treatment regimens that excluded craniotomy. In a multivariate analysis, only treatment type was significant in predicting survival. Conclusion: OBM portends a poor prognosis, however, long-term survival is possible. Patients appear to benefit from therapy, especially selected groups of OBM patients with single brain metastasis treated with radiation therapy and surgery.

AB - Purpose: To better define determinants of survival and optimal management strategies for patients with ovarain cancer and brain metastases. Methods: A review of literature using Medline identified 15 case series of ovarian cancer patients with brain metastases (OBM). Each article was abstracted for survival data, and in all cases, the intervals between ovarian cancer diagnosis and brain metastasis identification, and between brain metastasis identification and last follow-up were recorded. Cases were categorized by patient characteristics and treatment modality for brain metastases. Estimated survival probabilities were plotted using the Kaplan-Meier method with differences between subgroups analyzed by the log-rank test. Cox proportional hazards model was used to identify independent prognostic factors age, number of metastasis, and treatment modality associated with survival. Results: The median interval from ovarian cancer diagnosis to brain metastasis in 104 identified patients was 19.5 months. Brain metastasis was single in 43%, multiple in 41%, and not reported in 16% of cases. About 81.7% of patients were treated for their brain metastases using external radiation therapy (XRT), chemotherapy, and surgery. XRT was utilized in 76% of 104 patients and in 93% of treated patients. The most commonly used modalities were XRT alone (40%) and craniotomy and XRT (17%). The median survival (MS) for all patients regardless of treatment type was 6 months. Patients who received any treatment lived longer than those not receiving surgery/chemotherapy/XRT (MS; 7 months vs. 2 months, P=0.0001). Patients with single brain metastasis had a longer median survival (21 months vs. 6 months, P = 0.049) when treated with craniotomy plus radiation and/or chemotherapy compared to treatment regimens that excluded craniotomy. In a multivariate analysis, only treatment type was significant in predicting survival. Conclusion: OBM portends a poor prognosis, however, long-term survival is possible. Patients appear to benefit from therapy, especially selected groups of OBM patients with single brain metastasis treated with radiation therapy and surgery.

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