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Brain metastases from endometrial carcinoma: a retrospective study
Lilian T Gien1, Janice S Kwon, David P D'Souza
1Department of Obstetrics and Gynecology, London Health Sciences Centre, University of Western Ontario, Canada.
Objective:
The objective of this study was to examine the characteristics and treatment results of patients at our center with brain metastases from endometrial carcinoma.
Methods:
Between January 1991 and March 2003, there were 1295 women referred to the London Regional Cancer Centre with the diagnosis of endometrial cancer, and eight of these women (0.6%) developed brain metastases. The medical records of these eight women were reviewed to assess patient and tumor characteristics at primary diagnosis. Treatment and clinical outcomes were analyzed.
Results:
The majority of patients had poor prognostic factors associated with the primary tumor, including high grade and advanced stage. The median age at diagnosis of brain metastases was 66 years. The median interval between completion of primary tumor treatment and diagnosis of brain metastases was 2 months. Three patients had no other evidence of systemic disease, while five had disseminated disease. Four patients had a single brain metastasis, while four had multiple lesions. Seven patients received whole brain radiation therapy in addition to systemic steroids, of which six had temporary improvement or resolution in symptoms. Median survival following diagnosis of brain metastases was 3.5 months.
Conclusions:
Brain metastases from endometrial cancer are uncommon. Associated factors include high grade and advanced stage. The majority of women in this series presented with brain metastases shortly after completion of primary treatment for their endometrial cancer. The prognosis following brain metastases is generally very poor. Innovative treatment strategies are needed to improve the outcome of these patients.