Brain metastases in patients with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19). Marchetti, C., Ferrandina, G., Cormio, G., Gambino, A., Cecere, S., Lorusso, D., De Giorgi, U., Bogliolo, S., Fagotti, A., Mammoliti, S., Narducci, F., Bergamini, A., Scollo, P., Biglia, N., Breda, E., Tamberi, S., Marinaccio, M., Angioli, R., Salerno, L., Eusebi, M. C., Loizzi, V., Scambia, G., & Panici, P. B. Gynecol Oncol, 143(3):532–538, December, 2016.
Brain metastases in patients with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19) [link]Paper  doi  abstract   bibtex   
BACKGROUND: Brain metastases (BM) from epithelial ovarian cancer (EOC) are considered a rare and unfavourable event. There is no consensus regarding the best management of these patients. METHODS: A multicenter retrospective analysis of patients with BM from EOC treated between 1997 and 2014 in 18 institutions of the MITO (Multicenter Italian Trials in Ovarian cancer) group was conducted. Univariate and multivariate analysis were performed. RESULTS: A total of 174 women were identified as having BM from EOC. The median time interval between primary diagnosis of EOC and occurrence of BM was 26months (range 2-129months). The median overall survival from primary EOC diagnosis was 48months (95% CI 39.5-56.4months) and from diagnosis of BM was 12months (95% CI 9.6-14.3months). The majority of enrolled women (81.7%) were classified as sensitive to platinum-based chemotherapy. Four variables were significantly associated with poor overall survival in multivariate analysis: multiple BM [HR: 1.86 (95% CI: 1.22-2.84)], presence of extracranial disease [HR: 1.77 (95% CI: 1.11-2.83)] age [HR: 1.74 (95% CI: 1.17-2.59)], and monotherapy [HR: 2.57 (95% CI: 1.64-3.86)]. On the contrary, residual tumor at primary surgery, FIGO stage at primary diagnosis and platinum sensitivity were found to have no significant impact on survival from diagnosis of brain lesions. CONCLUSIONS: Our results suggest that BM is a rare and late manifestation of EOC, with a 12-month life-span expectation. Multiple approach is a positive independent prognostic factor and should be proposed to carefully selected patients.
@article{marchetti_brain_2016,
	title = {Brain metastases in patients with {EOC}: {Clinico}-pathological and prognostic factors. {A} multicentric retrospective analysis from the {MITO} group ({MITO} 19)},
	volume = {143},
	issn = {1095-6859 (Electronic) 0090-8258 (Linking)},
	shorttitle = {Brain metastases in patients with {EOC}: {Clinico}-pathological and prognostic factors. {A} multicentric retrospective analysis from the {MITO} group ({MITO} 19)},
	url = {http://www.ncbi.nlm.nih.gov/pubmed/27717490},
	doi = {10.1016/j.ygyno.2016.09.025},
	abstract = {BACKGROUND: Brain metastases (BM) from epithelial ovarian cancer (EOC) are considered a rare and unfavourable event. There is no consensus regarding the best management of these patients. METHODS: A multicenter retrospective analysis of patients with BM from EOC treated between 1997 and 2014 in 18 institutions of the MITO (Multicenter Italian Trials in Ovarian cancer) group was conducted. Univariate and multivariate analysis were performed. RESULTS: A total of 174 women were identified as having BM from EOC. The median time interval between primary diagnosis of EOC and occurrence of BM was 26months (range 2-129months). The median overall survival from primary EOC diagnosis was 48months (95\% CI 39.5-56.4months) and from diagnosis of BM was 12months (95\% CI 9.6-14.3months). The majority of enrolled women (81.7\%) were classified as sensitive to platinum-based chemotherapy. Four variables were significantly associated with poor overall survival in multivariate analysis: multiple BM [HR: 1.86 (95\% CI: 1.22-2.84)], presence of extracranial disease [HR: 1.77 (95\% CI: 1.11-2.83)] age [HR: 1.74 (95\% CI: 1.17-2.59)], and monotherapy [HR: 2.57 (95\% CI: 1.64-3.86)]. On the contrary, residual tumor at primary surgery, FIGO stage at primary diagnosis and platinum sensitivity were found to have no significant impact on survival from diagnosis of brain lesions. CONCLUSIONS: Our results suggest that BM is a rare and late manifestation of EOC, with a 12-month life-span expectation. Multiple approach is a positive independent prognostic factor and should be proposed to carefully selected patients.},
	number = {3},
	journal = {Gynecol Oncol},
	author = {Marchetti, C. and Ferrandina, G. and Cormio, G. and Gambino, A. and Cecere, S. and Lorusso, D. and De Giorgi, U. and Bogliolo, S. and Fagotti, A. and Mammoliti, S. and Narducci, F. and Bergamini, A. and Scollo, P. and Biglia, N. and Breda, E. and Tamberi, S. and Marinaccio, M. and Angioli, R. and Salerno, L. and Eusebi, M. C. and Loizzi, V. and Scambia, G. and Panici, P. B.},
	month = dec,
	year = {2016},
	keywords = {Adult, Aged, Female, Humans, Middle Aged, Retrospective Studies, Aged, 80 and over, Prognosis, Survival Rate, Proportional Hazards Models, Multivariate Analysis, Chemoradiotherapy, Adenocarcinoma, Clear Cell/complications/secondary/*therapy, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Brain Neoplasms/complications/secondary/*therapy, Carboplatin/administration \& dosage, Carcinoma, Endometrioid/complications/secondary/*therapy, Cisplatin/administration \& dosage, Confusion/etiology, Cranial Irradiation, Headache/etiology, Metastasectomy, Nausea/etiology, Neoplasms, Cystic, Mucinous, and Serous/complications/secondary/*therapy, Neurosurgical Procedures, Ovarian Neoplasms/*pathology, Seizures/etiology, Vertigo/etiology, Vomiting/etiology},
	pages = {532--538}
}
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