PLoS ONE (Jan 2022)

Prognostic features of endometrial cancer metastasis to the central nervous system.

  • Michelle L Kuznicki,
  • Adrianne Mallen,
  • Kristal Ha,
  • Emily Clair McClung,
  • Antonio V Castaneda,
  • Biwei Cao,
  • Brooke L Fridley,
  • Hye Sook Chon,
  • Jing Yi Chern,
  • Mitchel Hoffman,
  • Robert M Wenham,
  • Koji Matsuo,
  • Mian M K Shahzad

DOI
https://doi.org/10.1371/journal.pone.0268794
Journal volume & issue
Vol. 17, no. 8
p. e0268794

Abstract

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ObjectivesCentral nervous system metastases (CNSm) secondary to endometrial cancer (EC) are rare. As a result, prognostic factors for this patient population are not well described.MethodsEC patients with CNSm were identified retrospectively from two academic centers. EC patients without CNSm (non-CNSm) were used as controls. Chi-square and Fisher's exact tests were used for analysis of categorial variables. Wilcoxon tests were used for quantitative measures. Overall survival (OS) was compared with Log-rank test. Cox proportional hazard models were used to estimate hazard ratios for OS.Results22 EC patients with CNSm and 354 non-CNSm patients were included. Compared to non-CNSm EC, the CNSm cohort was younger (58.5 vs 62.0 years, p = 0.018) with lower BMI (27.7 vs. 33.7 kg/m2, p = 0.005), and had more advanced stages (p = ≤ 0.001), grade 3 tumors (81.8% CNSm vs 25.1% non CNSm, p≤0.001) and serous histology (22.7% vs 8.5%, p = 0.010). Median survival after CNSm diagnosis was 9 months (95% CI 4, NA). CNSm was a strong poor prognostic factor (HR death 4.96, p = 0.022). Improved OS was seen with CNS as the only disease site (83m CNSm only vs 30m additional sites, p = 0.007) and less than five CNSm (49m ConclusionsCNSm is a poor prognostic factor in EC, however, low volume disease with aggressive treatment may result in more favorable survival outcomes.