J Cancer 2020; 11(15):4625-4640. doi:10.7150/jca.44494

Research Paper

Prognostic Factors among Brain Metastases in Newly Diagnosed Ovary Cancer: A Large Real-world Study

Sujuan Xi1,#, Zaiyi Li1,#, Quan Guo2,#, Wenjing Lin1, Xiaokun Liang3, Lin Ma1,✉

1. The Reproductive Medical Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
2. Department of gynaechology, Shengjing Hospital Medical University, Shenyang, China
3. Shenzhen Colleges of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055 China
# The authors contributed equally to this work.

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Citation:
Xi S, Li Z, Guo Q, Lin W, Liang X, Ma L. Prognostic Factors among Brain Metastases in Newly Diagnosed Ovary Cancer: A Large Real-world Study. J Cancer 2020; 11(15):4625-4640. doi:10.7150/jca.44494. Available from http://www.jcancer.org/v11p4625.htm

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Abstract

Background: Population-based data on the prognosis of brain metastases at initial diagnosis of ovary cancer (OCBM) are currently lacking. Besides, the effective treatment for OCBM patients is still controversial now. The study aimed to explore the prognostic factors among OCBM.

Methods: We retrospectively reviewed the OCBM patients from the Surveillance, Epidemiology, and End Result (SEER) database of the National Cancer Institute to investigate predictors of the presence of OCBM and its' prognostic factors related to all-cause mortality. We employed multivariable logistic and Cox regression analysis. Furthermore, to minimize the impact of potential confounding factors, we conducted a 1:1 propensity score matching (PSM) analysis.

Results: A total of 29,512 cases of OC patients entered into the study, including 89 patients with brain metastases of ovarian cancer, which accounted for 0.30% of the entire cohort and 12.02% of the metastatic disease subset. We identified eight factors, including laterality, histology, surgery, radiotherapy, chemotherapy, and extracranial metastatic sites to bone, liver, and lung, as predictors of OCBM based on multivariable logistic regression among the entire cohort. The median survival time of OCBM was 2.0 months, and the interquartile range was 2.0-10.0 mo. The patients who received comprehensive treatment had better prognosis. Based on the multivariable Cox model, marital status, surgery, chemotherapy, and extensive therapy (including RSC, SC, and RC) were identified as predictors of OS. Besides, a new factor (brain metastasis) was identified by 1:1 PSM -based multiple Cox regression, apart from the above prognostic factors for OS.

Conclusions: This study provided a population-based estimate of the proportion and prognosis for newly diagnosed ovary cancer with brain metastases. These findings may add materials to guidelines for preliminary screening and optimal treatment of OCBM patients.

Keywords: Ovarian cancer, Brain metastases, Prognosis, associated factor, SEER