Clinical features and prognostic factors of ovarian cancer brain metastases from ovarian cancer: a retrospective multicenter study of 129 cases.

BACKGROUND

Ovarian cancer brain metastases (OCBM) are rare and have poor prognosis, with limited clinical management guidelines. This study aimed to identify prognostic factors and optimal treatment approaches for patients with OCBM.

METHODS

We conducted a retrospective multicenter analysis of patients with OCBM from 12 hospitals in China from May 2010 to May 2022. The primary outcomes were overall survival (OS) and brain metastasis-specific survival (BMSS). Kaplan-Meier and Cox regression analyses were used to assess treatment outcomes and identify prognostic risk factors.

RESULTS

In total, 129 patients with OCBM were included. The median interval from ovarian cancer diagnosis to brain metastasis (BM) was 25.74 (range: 0-103.1) months. Headache attributed to BM was the most common presenting symptom, reported in 64 (49.6%) patients, followed by paralysis in 23 (17.8%) patients. The cerebellum and brainstem were the most frequent metastatic sites (36 patients, 27.9%), followed by the frontal lobe (27 patients, 20.9%). In BMSS analysis, multiple BM lesions (hazard ratio [HR]: 2.060; 95% confidence interval [CI]: 1.308-3.244; P = 0.002), headache attributed to BM (HR: 1.765; 95% CI: 1.049-2.968; P = 0.032), and relapse lines before BM diagnosis (HR: 2.060; 95% CI: 1.308-3.244; P = 0.002) were independent predictors of worse BMSS. Subgroup Kaplan-Meier analysis showed that patients with a single BM lesion achieved significantly better outcomes with stereotactic radiosurgery (SRS) compared with those having multiple lesions.

CONCLUSION

This study demonstrates that patients with a single BM lesion may benefit from SRS, whereas those with multiple lesions require more individualized treatment strategies.