Gonnet Philippe, Marinari Eliana, Achard Vérane, Schaffar Robin, Neyroud-Caspar Isabelle, May Adrien, Goga Cristina, Dietrich Pierre-Yves, Schaller Karl, Patrikidou Anna
Department of Internal Medicine, Hôpital de la Tour, 1217 Meyrin, Switzerland.
Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland.
Cancers (Basel). 2024 Oct 10;16(20):3437. doi: 10.3390/cancers16203437.
Incidence of brain metastases is precisely unknown and there is no clear consensus on their management. We aimed to determine the incidence of brain metastases among patients with genito-urinary primaries, present patients' characteristics and identify prognostic factors.
We identified 51 patients treated in Geneva University Hospitals between January 1992 and December 2019. We retrospectively correlated their overall survival with 23 variables. We repeated a multivariate analysis with significant variables.
Overall incidence of Brain Metastases (BMs) among Genito-Urinary (GU) patients is estimated to be 1.76% (range per primary GU tumour type: 0.00-6.65%). BMs originate from germ cell tumours in two cases (3.92%), from urothelial cell carcinoma in 15 cases (29.41%), from prostate cancer in 13 cases (25.49%), and from renal cell carcinoma in 21 cases (41.18%); there are no BMs from penile cancer in our cohort. The median age at BM diagnosis is 67 years old (range: 25-92). Most patients (54%) have a stage IV disease at initial diagnosis and 11 patients (22%) have BM at initial diagnosis. Only six patients (12%) are asymptomatic at BM diagnosis. The median Overall Survival (OS) from BM diagnosis is 3 months (range: 0-127). Five patients (10%) are long survivors (OS > 24 months). OS is significantly influenced by patient performance status and administration of systemic treatment. In the absence of meningeal carcinomatosis, OS is influenced by systemic treatment and stereotactic radiosurgery. We also apply the Graded Prognostic Assessment (GPA) score to our cohort and note significant differences between groups.
Brain metastases from solid tumours is not a uniform disease, with a prognosis varying a lot among patients. The optimal management for patients with genito-urinary malignancies with brain metastases remain unclear and further research is needed.
脑转移瘤的发病率确切未知，其治疗也尚无明确共识。我们旨在确定泌尿生殖系统原发性肿瘤患者中脑转移瘤的发病率，呈现患者特征并识别预后因素。
我们确定了1992年1月至2019年12月期间在日内瓦大学医院接受治疗的51例患者。我们回顾性地将他们的总生存期与23个变量相关联。我们对显著变量进行了多变量分析。
泌尿生殖系统（GU）患者中脑转移瘤（BMs）的总体发病率估计为1.76%（每种原发性GU肿瘤类型的范围：0.00 - 6.65%）。BMs起源于2例生殖细胞肿瘤（3.92%），15例尿路上皮细胞癌（29.41%），13例前列腺癌（25.49%），21例肾细胞癌（41.18%）；我们的队列中没有来自阴茎癌的BMs。BM诊断时的中位年龄为67岁（范围：25 - 92岁）。大多数患者（54%）在初始诊断时为IV期疾病，11例患者（22%）在初始诊断时即有BM。只有6例患者（12%）在BM诊断时无症状。从BM诊断起的中位总生存期（OS）为3个月（范围：0 - 127个月）。5例患者（10%）为长期存活者（OS > 24个月）。OS受患者的体能状态和全身治疗的显著影响。在没有脑膜癌病的情况下，OS受全身治疗和立体定向放射外科的影响。我们还对我们的队列应用了分级预后评估（GPA）评分，并注意到各亚组之间存在显著差异。
实体瘤脑转移瘤并非一种统一的疾病，患者预后差异很大。泌尿生殖系统恶性肿瘤伴脑转移患者的最佳治疗方案仍不明确，需要进一步研究。
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