Journal of gynecologic oncology · 2022
Incidence and risk factors for the development of cerebral metastasis in cervical cancer patients.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Rangel Juliana de Brito, Giglio Alessandra Grasso, Cardozo Cristiane Lemos, Bergmann Anke, Thuler Luiz Claudio Santos
Аннотация
OBJECTIVE: Cerebral metastasis (CM) in cervical cancer (CC) cases, although rare, results in high lethality rates. The present study aimed to assess CM incidence in a Brazilian reference CC center and evaluate the risk factors for CM development. Retrospective observational study of patients diagnosed with CC between 2010 and 2017.
METHODS: Cumulative CM incidence and incidence density were evaluated. Characteristics associated to CM development risks were identified using crude (cOR) or adjusted (aOR) odds ratios.
RESULTS: A total of 3,397 patients were included in this study. Patient age ranged from 18 to 101 years, with a mean age of 48.8±14.0. After a mean follow-up time of 3.2±2.1 years, 51 CM cases were identified, resulting in a cumulative incidence of 1.5% (95% confidence intervals [CI]=1.12-1.97) and an incidence density at the end of the 6th year of 27.4 per 1,000 women/year. Advanced clinical stage (aOR=3.15; 95% CI=1.16-8.58; p=0.025), the presence of previous lung metastasis (aOR=4.04; 95% CI=1.82-8.94; p=0.001) and the adenocarcinoma (aOR=2.90; 95% CI=1.46-5.76; p=0.002), adenosquamous carcinoma (aOR=7.33; 95% CI=2.87-18.73; p<0.001), undifferentiated carcinoma (aOR=14.37; 95% CI=3.77-54.76; p<0.001) and neuroendocrine carcinoma (aOR=21.31; 95% CI=6.65-68.37, p<0.001) histological types were associated with a higher risk for CM development. CM risk was higher in the first years of follow-up, with no cases observed after the 6th year.
CONCLUSION: CC patients in advanced clinical stages, displaying previous lung metastasis and non-squamous histological types are at high risk of developing CM.
METHODS: Cumulative CM incidence and incidence density were evaluated. Characteristics associated to CM development risks were identified using crude (cOR) or adjusted (aOR) odds ratios.
RESULTS: A total of 3,397 patients were included in this study. Patient age ranged from 18 to 101 years, with a mean age of 48.8±14.0. After a mean follow-up time of 3.2±2.1 years, 51 CM cases were identified, resulting in a cumulative incidence of 1.5% (95% confidence intervals [CI]=1.12-1.97) and an incidence density at the end of the 6th year of 27.4 per 1,000 women/year. Advanced clinical stage (aOR=3.15; 95% CI=1.16-8.58; p=0.025), the presence of previous lung metastasis (aOR=4.04; 95% CI=1.82-8.94; p=0.001) and the adenocarcinoma (aOR=2.90; 95% CI=1.46-5.76; p=0.002), adenosquamous carcinoma (aOR=7.33; 95% CI=2.87-18.73; p<0.001), undifferentiated carcinoma (aOR=14.37; 95% CI=3.77-54.76; p<0.001) and neuroendocrine carcinoma (aOR=21.31; 95% CI=6.65-68.37, p<0.001) histological types were associated with a higher risk for CM development. CM risk was higher in the first years of follow-up, with no cases observed after the 6th year.
CONCLUSION: CC patients in advanced clinical stages, displaying previous lung metastasis and non-squamous histological types are at high risk of developing CM.