Brain metastasis in epithelial ovarian cancer by BRCA1/2 mutation status.
Gynecol Oncol
; 154(1): 144-149, 2019 07.
Article
en En
| MEDLINE
| ID: mdl-31113680
ABSTRACT
OBJECTIVE:
To evaluate clinical outcomes of patients with BRCA-associated ovarian cancer who developed brain metastases (BM).METHODS:
Patients with epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) and BM, treated at a single institution from 1/1/2008-7/1/2018, were identified from two institutional databases. Charts and medical records were retrospectively reviewed for clinical characteristics and germline BRCA mutation status. Appropriate statistics were used.RESULTS:
Of 3649 patients with EOC, 91 had BM (2.5%). Germline mutation status was available for 63 (69%) cases; 21 (35%) of these harbored a BRCA1/2 mutation (15 BRCA1, 6 BRCA2). Clinical characteristics were similar between groups. BM were diagnosed at a median of 31â¯months (95% CI, 22.6-39.4) in BRCA-mutated (mBRCA) and 32â¯months (95% CI, 23.7-40.3) in wild-type BRCA (wtBRCA) (pâ¯=â¯0.78) patients. Brain metastases were the only evidence of disease at time of BM diagnoses in 48% (nâ¯=â¯10) mBRCA and 19% (nâ¯=â¯8) wtBRCA (pâ¯=â¯0.02) patients. There was no difference in treatment of BM by mutation status (pâ¯=â¯0.84). Survival from time of BM diagnosis was 29â¯months (95%CI, 15.5-42.5) in mBRCA and 9â¯months (95% CI, 5.5-12.5) in wtBRCA patients, with an adjusted hazard ratio (HR) of 0.53, pâ¯=â¯0.09; 95% CI, 0.25-1.11. HR was adjusted for presence of systemic disease at time of BM diagnosis.CONCLUSION:
This is the largest study to date comparing outcomes in patients with EOC and BM by mutation status. mBRCA patients were more likely to have isolated BM, which may be a factor in their long survival. This supports the pursuit of aggressive treatment for mBRCA EOC patients with BM. Additional studies examining the correlation of BRCA mutational status with BM are warranted.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Encefálicas
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Mutación de Línea Germinal
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Genes BRCA1
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Genes BRCA2
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Carcinoma Epitelial de Ovario
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Gynecol Oncol
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos