Brain metastases in epithelial ovarian carcinoma

Central nervous system metastases from epithelial ovarian carcinoma are uncommon. A retrospective study was undertaken to see if there was a difference in brain metastases from ovarian cancer in our patient population as compared to the literature. A retrospective study of all patients diagnosed with brain metastases from epithelial ovarian carcinoma at two institutions was performed. All patients were analyzed for stage, grade, type of chemotherapy, sites of recurrence, time to relapse, and survival after relapse. The results were compared to a compilation of reported cases from the literature. Sixteen patients with central nervous system metastases of 479 patients treated for ovarian carcinoma between January 1, 1979 and December 31, 1992 were identified. All 16 patients were diagnosed with serous cystadenocarcinoma, and all were either stage III or IV on presentation. Fifteen of the 16 patients had grade 2 or 3 disease. Histologic grade, at the time of diagnosis, did not influence survival after central nervous system recurrence; however, stage at original diagnosis did influence survival after brain metastases (P < 0.001). Eight of 11 patients undergoing second-look laparotomy had no evidence of disease. The most common presenting symptom of central nervous system disease was a slowly worsening headache of several weeks duration. The median time from original diagnosis to diagnosis of central nervous system disease was 19 months with a median survival after diagnosis of central nervous system disease of 3 months. The incidence of brain metastases in patients with epithelial ovarian carcinoma in our institutions was 3.3%. In conclusion, our incidence of brain metastases of 3.3% was not statistically significant from other reported rates. Patients who underwent radiation therapy with either craniotomy or chemotherapy for their brain metastases fared better than those who received radiation alone.