Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Nov;34(6):1324-1332.
doi: 10.3904/kjim.2018.051. Epub 2018 Oct 26.

The prognostic factors influencing overall survival in uterine cervical cancer with brain metastasis

Hyera Kim  1 , Kang Kook Lee  1 , Mi Hwa Heo  1 , Jin Young Kim  1
Affiliations
Comparative Study

The prognostic factors influencing overall survival in uterine cervical cancer with brain metastasis

Hyera Kim et al. Korean J Intern Med. 2019 Nov.

Abstract

Background/aims: The occurrence of brain metastasis (BM) has increased due to improved overall survival (OS) in uterine cervical cancer. However, research about prognostic factors and therapeutic guidelines for BM in uterine cervical cancer remains scarce due to the rarity of BM in this type of cancer. The present study evaluated the clinical characteristics and prognostic factors influencing OS in patients with BM from uterine cervical cancer.

Methods: A total of 19 BM patients of uterine cervical cancer were analyzed retrospectively from January 1995 to December 2016.

Results: The median and mean OS of all patients was 9.6 and 15.4 months. Treatment (vs. palliative care, p < 0.001), fewer than three regimens of chemotherapy before BM (vs. ≥ 3, p < 0.013), and chemotherapy after BM (vs. absence, p < 0.001) significantly increased the OS time. The Karnofsky performance status ≥ 70 (vs. < 70, p = 0.213), single BM (vs. multiple BM, p = 0.157), and small cell carcinoma (vs. others, p = 0.351) had numerically higher OS than others. Dual therapy (vs. single therapy, p = 0.182; vs. no therapy, p = 0.076) were associated with a longer OS time, but the difference did not reach statistical significance. In addition, the graded prognostic assessment (GPA) appeared to be a better prognostic tool than the recursive partitioning analysis.

Conclusion: The results of the present study suggest active multimodal treatment including neurosurgery, radiotherapy, and chemotherapy for BM of uterine cervical cancer with single BM, good performance status, histology of small cell carcinoma, and a better GPA.

Keywords: Brain metastasis; Prognosis; Uterine cervical neoplasms.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
The Kaplan-Meier survival curve in patients with brain metastasis from uterine cervical cancer. CI, confidence interval.
Figure 2.
Figure 2.
The Kaplan-Meier survival curves in patients with brain metastasis (BM) from uterine cervical cancer based on prognostic factors influencing the survival time: (A) the Karnofsky performance score (KPS, ≥ 70 vs. < 70), (B) histology (small cell carcinoma [SC] vs. others), (C) the number of chemotherapy (CTx) regimens before BM (≥ 3 vs. < 3), (D) the number of BM (single vs. multiple), (E) treatments for BM (treatment vs. palliative care), (F) CTx after BM (presence vs. absence). H, histology.
Figure 3.
Figure 3.
The Kaplan-Meier survival curve in patients with brain metastases from uterine cervical cancer based on the local treatment (Tx) modalities. Single therapy, neurosurgery or radiotherapy; double therapy, neurosurgery and radiotherapy.
Figure 4.
Figure 4.
(A) The Kaplan-Meier survival curves according to the recursive partitioning analysis (RPA) class for patients with uterine cervical cancer. (B) The Kaplan-Meier survival curves according to the graded prognostic assessment (GPA) for patients with uterine cervical cancer.
See this image and copyright information in PMC

References

    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108. - PubMed
    1. Jung KW, Won YJ, Oh CM, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017;49:292–305. - PMC - PubMed
    1. Sato Y, Tanaka K, Kobayashi Y, et al. Uterine cervical cancer with brain metastasis as the initial site of presentation. J Obstet Gynaecol Res. 2015;41:1145–1148. - PubMed
    1. Ogawa K, Yoshii Y, Aoki Y, et al. Treatment and prognosis of brain metastases from gynecological cancers. Neurol Med Chir (Tokyo) 2008;48:57–62. - PubMed
    1. Bindal RK, Sawaya R, Leavens ME, Lee JJ. Surgical treatment of multiple brain metastases. J Neurosurg. 1993;79:210–216. - PubMed

Publication types

MeSH terms