Prognostic factors in ovarian cancer patients with brain metastases: A retrospective analysis

Brain metastases (BM) from epithelial ovarian cancer (EOC) are rare but clinically significant due to their poor prognosis. This study aimed to investigate prognostic factors influencing survival in EOC patients who developed BM and to evaluate treatment-related outcomes.

A retrospective review was conducted on 1123 patients with EOC treated between 2008 and 2021. Among them, 27 patients (2.4 %) developed BM. Demographic, clinical, and treatment-related data were collected. Overall survival after BM diagnosis was assessed using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed on 21 patients who received active treatment (surgery and/or radiotherapy).

The median time from ovarian cancer diagnosis to BM was 27 months, and the median post-BM survival was 12 months. Survival was significantly longer in platinum-sensitive patients (38 vs. 7 months, p = 0.04). Median survival was 30 months with combined therapy, 13 months with radiotherapy alone, and 1 month with palliative care (p = 0.01). Within the radiotherapy group, the median survival was 13 months in patients treated with stereotactic radiosurgery (SRS) and 6 months in those who received whole-brain radiotherapy (WBRT). Univariate analysis identified platinum sensitivity (p = 0.075), number of metastases (p = 0.017), and lesion localization (p = 0.021) as factors associated with survival. In multivariate analysis, platinum sensitivity remained the only independent predictor of improved survival (HR: 0.34; 95 % CI: 0.16-0.71; p = 0.04).

Platinum sensitivity is a key prognostic determinant in ovarian cancer patients with BM. Early identification and tailored multimodal treatment strategies may contribute to prolonged survival in selected patients.