Prognostic factors in ovarian cancer patients with brain metastases: Results of a German multicenter study

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e16527 Background: Ovarian cancer is one of the leading causes of mortality in women with gynaecological malignancies. Brain metastases from ovarian cancer are rare. Up to this point there are only few data about prognostic factors for this patient collective. Methods: Within a period between 1981 and 2008 we analyzed 4,277 women with histologically confirmed ovarian cancer from six different German hospitals. Overall 72 women with brain metastases and two cases of meningosis carcinomatosa were identified, these resulting in an incidence of 1.73%. Results: The median age at the diagnosis of central nervous system (CNS) metastases was 58 years (range, 33–83). The median interval between the time of the first diagnosis of ovarian cancer and the occurrence of CNS metastases was 28.8 months (range, 3.6 -133.1). The median overall survival time after diagnosis of CNS metastases was 6.1 months (range, 0.2 -41.5). Multiple brain metastases were observed in 58 women (78.4%). Headache (36.5%), vomiting and nausea (17.1%) were the most frequent clinical symptoms. According the multivariate analysis following clinical parameter reached statistical significance: multiple lesions (hazard ratio (HR): 4.1, 95% confidence intervaI (CI): 1.9 to 8.9), grading I und II (HR: 2.8, 95% CI: 1.6 to 5.0) were associated with a negative impact on overall survival. Platinum sensitivity (HR: 0.28, 95% CI: 0.15 to 0.52) and the application of multimodal therapy strategies (surgery, radiotherapy and chemotherapy) (HR: 0.51, 95% CI: 0.28 to 0.92) and the good performance (HR: 0.52; 95% CI: 0.25 to 1.08) showed a positive impact on overall survival. Tumour histology, ascites and age at the CNS diagnosis were not significant for the survival. Conclusions: Next to the presence of multiple brain lesions and the performance status, the sensitivity to platinum based chemotherapy has an important positive impact on overall survival. This should be considered in the conduction of multimodal therapy strategies for brain metastases from ovarian cancer. No significant financial relationships to disclose.

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