Platinum sensitivity and CD133 expression as risk and prognostic predictors of central nervous system metastases in patients with epithelial ovarian cancer.
BACKGROUND
To characterize prognostic and risk factors of central nervous system (CNS) metastases in patients with epithelial ovarian cancer (EOC).


METHODS
A retrospective analysis of Xijing Hospital electronic medical records was conducted to identify patients with pathologically confirmed EOC and CNS metastases. In addition to patient demographics, tumor pathology, treatment regimens, and clinical outcomes, we compared putative cancer stem cell marker CD133 expression patterns in primary and metastatic lesions as well as in recurrent EOC with and without CNS metastases.


RESULTS
Among 1366 patients with EOC, metastatic CNS lesions were present in 29 (2.1%) cases. CD133 expression in primary tumor was the only independent risk factor for CNS metastases; whilst the extent of surgical resection of primary EOC and platinum resistance were two independent factors significantly associated with time to CNS metastases. Absence of CD133 expression in primary tumors was significantly associated with high platinum sensitivity in both patient groups with and without CNS metastases. Platinum resistance and CD133 cluster formation in CNS metastases were associated with decreased survival, while multimodal therapy including stereotactic radiosurgery (SRS) for CNS metastases was associated with increased survival following the diagnosis of CNS metastases.


CONCLUSIONS
These data suggest that there exist a positive association between CD133 expression in primary EOC, platinum resistance and the increased risk of CNS metastases, as well as a less favorable prognosis of EOC. The absence of CD133 clusters and use of multimodal therapy including SRS could improve the outcome of metastatic lesions. Further investigation is warranted to elucidate the true nature of the association between platinum sensitivity, CD133 expression, and the risk and prognosis of CNS metastases from EOC.
Bo-Lin
BL
Liu
Shu-Juan
SJ
Liu
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, West Changle Road, No,127, Xi'an 710032 Shaanxi Province People's Republic of China. abaskys@ucr.edu.
Andrius
A
Baskys
Hong
H
Cheng
Ying
Y
Han
Chao
C
Xie
Hui
H
Song
Jia
J
Li
Xiao-Yan
XY
Xin
D000071916:AC133 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000077216:Carcinoma, Ovarian Epithelial; D016543:Central Nervous System Neoplasms / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D006023:Glycoproteins / Q000032:analysis*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000737:chemistry* / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000473:pathology* / Q000628:therapy; D010455:Peptides / Q000032:analysis*; D017671:Platinum Compounds / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
D000071916:AC133 Antigen; D015703:Antigens, CD; D000970:Antineoplastic Agents; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D017671:Platinum Compounds