Cargando…

Brain metastases from cervical cancer reduce longevity independent of overall tumor burden

BACKGROUND: Isolated brain metastasis (IBM) from cervical cancer is a very rare encounter in neurosurgery. We sought to understand how patients with isolated brain metastases differ from those with metastases in the setting of widespread disease. METHODS: A systematic review was completed using PubM...

Descripción completa

Detalles Bibliográficos
Autores principales: Takayanagi, Ariel, Florence, T. J., Hariri, Omid R., Armstrong, Abigail, Yazdian, Pouria, Sumida, Andrew, Quadri, Syed A., Cohen, Joshua, Tehrani, Omid S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763668/
https://www.ncbi.nlm.nih.gov/pubmed/31583173
http://dx.doi.org/10.25259/SNI_37_2019
_version_ 1783454246023200768
author Takayanagi, Ariel
Florence, T. J.
Hariri, Omid R.
Armstrong, Abigail
Yazdian, Pouria
Sumida, Andrew
Quadri, Syed A.
Cohen, Joshua
Tehrani, Omid S.
author_facet Takayanagi, Ariel
Florence, T. J.
Hariri, Omid R.
Armstrong, Abigail
Yazdian, Pouria
Sumida, Andrew
Quadri, Syed A.
Cohen, Joshua
Tehrani, Omid S.
author_sort Takayanagi, Ariel
collection PubMed
description BACKGROUND: Isolated brain metastasis (IBM) from cervical cancer is a very rare encounter in neurosurgery. We sought to understand how patients with isolated brain metastases differ from those with metastases in the setting of widespread disease. METHODS: A systematic review was completed using PubMed and the Cochrane Library. Patients with isolated brain metastases (IBM) and non-isolated brain metastases (NIBM, or brain metastases in the setting of disseminated disease), were compared. Two-sided statistical tests were used to determine significance. Survival function was carried out using the Kaplan–Meier method. RESULTS: A total of 89 patients, 25 with IBM and 64 with NIBM, were identified. The time interval between initial diagnosis of cervical cancer and diagnosis of brain lesion was significantly shorter in the IBM group (median 7.5 vs. 20.05 months, and IBM vs. NIBM, respectively; P = 0.006). Overall survival from initial diagnosis of cervical cancer was significantly shorter for the IBM group versus the NIBM group (7.63 vs. 26.3 months, respectively; P = 0.0005). Data demonstrate a 3.4-fold reduction of median life expectancy to 7.63 months. Survival after diagnosis of brain metastases did not differ between groups (median, IBM 7 months vs. NIBM 4 months, P = 0.08). CONCLUSION: Taken together, our data suggest that for cervical cancer patients with brain metastasis intracranial metastasis itself (and not overall tumor burden) represent a sentinel event in limiting longevity. While the present study is underpowered to compare treatment options directly, further work should be focused on determining the optimal treatment for these patients.
format Online
Article
Text
id pubmed-6763668
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Scientific Scholar
record_format MEDLINE/PubMed
spelling pubmed-67636682019-10-03 Brain metastases from cervical cancer reduce longevity independent of overall tumor burden Takayanagi, Ariel Florence, T. J. Hariri, Omid R. Armstrong, Abigail Yazdian, Pouria Sumida, Andrew Quadri, Syed A. Cohen, Joshua Tehrani, Omid S. Surg Neurol Int Original Article BACKGROUND: Isolated brain metastasis (IBM) from cervical cancer is a very rare encounter in neurosurgery. We sought to understand how patients with isolated brain metastases differ from those with metastases in the setting of widespread disease. METHODS: A systematic review was completed using PubMed and the Cochrane Library. Patients with isolated brain metastases (IBM) and non-isolated brain metastases (NIBM, or brain metastases in the setting of disseminated disease), were compared. Two-sided statistical tests were used to determine significance. Survival function was carried out using the Kaplan–Meier method. RESULTS: A total of 89 patients, 25 with IBM and 64 with NIBM, were identified. The time interval between initial diagnosis of cervical cancer and diagnosis of brain lesion was significantly shorter in the IBM group (median 7.5 vs. 20.05 months, and IBM vs. NIBM, respectively; P = 0.006). Overall survival from initial diagnosis of cervical cancer was significantly shorter for the IBM group versus the NIBM group (7.63 vs. 26.3 months, respectively; P = 0.0005). Data demonstrate a 3.4-fold reduction of median life expectancy to 7.63 months. Survival after diagnosis of brain metastases did not differ between groups (median, IBM 7 months vs. NIBM 4 months, P = 0.08). CONCLUSION: Taken together, our data suggest that for cervical cancer patients with brain metastasis intracranial metastasis itself (and not overall tumor burden) represent a sentinel event in limiting longevity. While the present study is underpowered to compare treatment options directly, further work should be focused on determining the optimal treatment for these patients. Scientific Scholar 2019-09-13 /pmc/articles/PMC6763668/ /pubmed/31583173 http://dx.doi.org/10.25259/SNI_37_2019 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Takayanagi, Ariel
Florence, T. J.
Hariri, Omid R.
Armstrong, Abigail
Yazdian, Pouria
Sumida, Andrew
Quadri, Syed A.
Cohen, Joshua
Tehrani, Omid S.
Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title_full Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title_fullStr Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title_full_unstemmed Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title_short Brain metastases from cervical cancer reduce longevity independent of overall tumor burden
title_sort brain metastases from cervical cancer reduce longevity independent of overall tumor burden
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763668/
https://www.ncbi.nlm.nih.gov/pubmed/31583173
http://dx.doi.org/10.25259/SNI_37_2019
work_keys_str_mv AT takayanagiariel brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT florencetj brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT haririomidr brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT armstrongabigail brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT yazdianpouria brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT sumidaandrew brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT quadrisyeda brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT cohenjoshua brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden
AT tehraniomids brainmetastasesfromcervicalcancerreducelongevityindependentofoveralltumorburden