Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
Ann Oncol. 2010 Nov;21(11):2201-2205. doi: 10.1093/annonc/mdq229. Epub 2010 May 3.
Ovarian cancer is the leading cause of death in women with gynecological malignancies. Brain metastases are considered an uncommon metastatic site. Only few data exist on prognostic factors for this patient collective.
A multicenter retrospective chart review was carried out including all patients with histologically confirmed ovarian cancer from six different German hospitals from 1981 to 2008. Overall, 4277 cases of patients with ovarian cancer were screened and patients with brain metastasis were identified and analyzed regarding various clinical variables and survival.
A total of 74 women with brain metastases were identified, resulting in an incidence of 1.73%. In multivariate analysis, the following clinical parameters had a significant impact on overall survival: multiple lesions [hazard ratio (HR) 4.4, 95% confidence interval (CI) 2.0-9.7] and low grading (HR 3.1, 95% CI 1.7-5.8) were associated with a negative impact. Platinum sensitivity (HR 0.23, 95% CI 0.12-0.48) was significantly associated with a favorable outcome. Good performance status (60%-80% HR 0.48, 95% CI 0.23-0.99 and 90%-100% HR 0.21, 95% CI 0.08-0.53) also had a positive impact on overall survival.
Platinum sensitivity is the most important prognostic factor in patients with ovarian cancer metastatic to the brain. This novel finding should be considered in the strategy of multimodal therapy for brain metastases in ovarian cancer.
卵巢癌是妇科恶性肿瘤患者死亡的主要原因。脑转移被认为是一种罕见的转移部位。针对这一患者群体，仅有少量预后因素的数据存在。
进行了一项多中心回顾性图表审查，纳入了 1981 年至 2008 年间来自德国六家不同医院的所有组织学证实的卵巢癌患者。总共筛选了 4277 例卵巢癌患者，确定并分析了有脑转移的患者的各种临床变量和生存情况。
共发现 74 例有脑转移的患者，发病率为 1.73%。多变量分析显示，以下临床参数对总生存有显著影响：多发转移灶[风险比（HR）4.4，95%置信区间（CI）2.0-9.7]和低分级（HR 3.1，95% CI 1.7-5.8）与不良预后相关。铂类药物敏感性（HR 0.23，95% CI 0.12-0.48）与良好结局显著相关。良好的体能状态（60%-80% HR 0.48，95% CI 0.23-0.99 和 90%-100% HR 0.21，95% CI 0.08-0.53）也对总生存有积极影响。
铂类药物敏感性是卵巢癌脑转移患者最重要的预后因素。这一新发现应在卵巢癌脑转移的多模式治疗策略中加以考虑。
