Prognostic role of platinum sensitivity in patients with brain metastases from ovarian cancer: results of a German multicenter study.
BACKGROUND
Ovarian cancer is the leading cause of death in women with gynecological malignancies. Brain metastases are considered an uncommon metastatic site. Only few data exist on prognostic factors for this patient collective.


METHODS
A multicenter retrospective chart review was carried out including all patients with histologically confirmed ovarian cancer from six different German hospitals from 1981 to 2008. Overall, 4277 cases of patients with ovarian cancer were screened and patients with brain metastasis were identified and analyzed regarding various clinical variables and survival.


RESULTS
A total of 74 women with brain metastases were identified, resulting in an incidence of 1.73%. In multivariate analysis, the following clinical parameters had a significant impact on overall survival: multiple lesions [hazard ratio (HR) 4.4, 95% confidence interval (CI) 2.0-9.7] and low grading (HR 3.1, 95% CI 1.7-5.8) were associated with a negative impact. Platinum sensitivity (HR 0.23, 95% CI 0.12-0.48) was significantly associated with a favorable outcome. Good performance status (60%-80% HR 0.48, 95% CI 0.23-0.99 and 90%-100% HR 0.21, 95% CI 0.08-0.53) also had a positive impact on overall survival.


CONCLUSIONS
Platinum sensitivity is the most important prognostic factor in patients with ovarian cancer metastatic to the brain. This novel finding should be considered in the strategy of multimodal therapy for brain metastases in ovarian cancer.
Sehouli
J
J
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin. Electronic address: sehouli@aol.com.
Pietzner
K
K
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
Harter
P
P
Department of Gynecology & Gynecologic Oncology, Dr. Horst Schmidt Klinik (HSK), Wiesbaden.
Münstedt
K
K
Department of Obstetrics and Gynecology, Justus-Liebig-University of Giessen, Giessen.
Mahner
S
S
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg.
Hasenburg
A
A
Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg.
Camara
O
O
Department of Gynaecology and Obstetrics, Friedrich Schiller University, Jena.
Wimberger
P
P
Department of Gynecology and Obstetrics, University Hospital Essen, Essen.
Boehmer
D
D
Department of Radiation Oncology and Radiotherapy, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin, Germany.
Buehling
K J
KJ
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg.
Richter
R
R
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
El Khalfaoui
K
K
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
Oskay-Ozcelik
G
G
Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D009944:Organoplatinum Compounds