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Published on: July 18, 2016
Ocular metastasis of primary gynecological malignancies, a rare but not insignificant entity: A systematic review
D E Vlachos1, N Thomakos1, D Haidopoulos1
1Gynecologic Oncology Unit, 1st Department of Obstetricsa and Gynecology, National and Kapodistrian University of Athens, Athens, Greece.
Abstract:
The genital system remains one of the most common sites of carcinogenesis in women. Advances in surgery, radiation treatment, and chemotherapy have increased their efficacy and many patients survive for many years after their initial diagnosis. The eye is a rare site of metastasis from gynecological cancer due to its distant location from the genitalia. In this systematic review, we retrieved all case reports of patients with ocular metastasis from gynecological neoplasms. The demographic, clinical, and treatment characteristics were retrieved and analyzed. A total of 70 case reports were included. Forty-eight of these reports concerned patients with a known malignancy that recurred in the eye and in 22 patients' ocular symptomatology accompanied the initial diagnosis of the gynecologic malignancy. 73.9% of these patients exhibited concomitant metastasis to other organs. The mean disease-free interval was found at 25.7 months and mean survival time after the eye metastasis was 13.5 months. Refractory disease was identified as the most important risk factor associated with mortality. Because eye metastasis has such a dismal prognosis, all gynecologists who treat oncological patients should be highly suspicious for reported eye complaints.
Insights
Ocular metastasis from gynecological cancer is rare but serious. Gynecologic oncologists should suspect eye metastasis in patients with visual symptoms, as it indicates a poor prognosis.
Area of Science:
- Gynecologic Oncology
- Ophthalmology
- Oncology
Background:
- Genital system cancers are common in women.
- Advances in treatment improve survival for many gynecological cancer patients.
- Ocular metastasis from gynecological cancer is rare due to anatomical distance.
Purpose of the Study:
- To systematically review case reports of ocular metastasis from gynecological neoplasms.
- To analyze demographic, clinical, and treatment characteristics of these cases.
- To identify risk factors and prognosis associated with ocular metastasis.
Main Methods:
- Systematic review of case reports.
- Inclusion of all reported cases of ocular metastasis from gynecological neoplasms.
- Analysis of demographic, clinical, and treatment data.
Main Results:
- 70 case reports were included.
- 48 cases involved recurrence, while 22 presented with initial diagnosis symptoms.
- 73.9% had concomitant metastasis to other organs.
- Mean disease-free interval was 25.7 months; mean survival post-ocular metastasis was 13.5 months.
- Refractory disease was the primary mortality risk factor.
Conclusions:
- Ocular metastasis from gynecological cancer carries a dismal prognosis.
- Gynecologic oncologists must maintain high suspicion for eye complaints in cancer patients.
- Early detection and awareness are crucial for managing this rare but severe complication.
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