The brain parenchymal metastases from serous ovarian cancer: 15 cases analysis

YUAN Jialu; JIANG Kui.

doi:10.3969/j.issn.1009-0460.2019.07.014

Abstract：Objective To investigate the clinical features, treatment and prognosis of serous ovarian cancer with brain paren?chymal metastases. Methods From Jan 2003 to Jan 2018,1138 cases of ovarian cancer patients were enrolled, and the clinical data of those with brain parenchymal metastases were analyzed. Results The incidence of brain parenchymal metastases in ovarian cancer was 1. 3%(15／1138)in this study. The pathological type of 15 patients with cerebral parenchymal metastases was serous, and 11 patients had complete differentiation of tumor, including 4 cases of moderate differentiation, 2 cases of moderate?poorly differentiation, and 5 cases of poorly differentiation. The most common symptom when diagnosed of cerebral parenchymal metastases was headache (6／15), and multiple metastases were found in 8 cases. Among the 15 cases, only 1 case had no extracranial metastases. The median level of CA125 when diagnosed of cerebral parenchymal metastases was 348. 2U／ml. After the diagnosis of cerebral parenchymal metastases, 8 patients underwent whole brain radiotherapy, 1 patient underwent surgery, 2 patients underwent surgery combined with radiotherapy, and 4 patients underwent chemotherapy. By following up the 15 patients, the median treatment?free survival was 4. 0 months, the medi?an progression?free survival from the diagnosis of ovarian cancer to the first disease progression was 12. 5 months, the median progres?sion?free survival from the first disease progression to cerebral parenchymal metastases was 25. 0 months, the median overall survival was 38. 5 months, and the median overall survival after cerebral parenchymal metastases was 10. 0 months. Conclusion Cerebral pa?renchymal metastases is rare in patients with ovarian cancer and the survival time is short. For patients of serous cancer, with elevated CA125 level, multi?organ metastases and long survival time, should be regarded as high?risk population of cerebral parenchymal metas?tases, and brain imaging is necessary during the follow?up.