Brain metastases in patients with low-grade endometrial carcinoma

Abstract

Objective: To report characteristics of patients with low-grade endometrioid endometrial carcinoma (EC) who develop brain metastases. Methods: We retrospectively identified all patients treated at our institution for FIGO grades 1/2 EC from 1/2000–12/2016, who developed brain metastases. Electronic medical records were reviewed, data abstracted. Overall survival (OS) was determined from time of brain metastases to death or last follow-up. Appropriate statistical tests were used. Results: Of 3052 patients, 23 (9, grade 1; 14, grade 2) developed brain metastases (incidence = 0.75%). Presentation at initial diagnosis: median age = 61.3 years (range, 41–81); median BMI = 29.8 kg/m2 (range, 20.3–42.6 kg/m2); distribution by stage: I, 15/23 (65%); II, 2/23 (8.7%); III, 3/23 (13.0%); IV, 3 (13.0%). None showed clinical evidence of brain metastases at presentation. Median time to diagnosis of brain metastases = 29.7 months (range, 6–145); median age = 64.6 years (range, 47.5–86.5). Brain metastases were the first, isolated site of recurrence in 2/23 (9%). All presented with neurological symptoms. Six (26%) had solitary brain lesions. Seventeen (74%) received treatment; 6 (28%), supportive care only. Median OS for patients receiving any treatment = 5.8 months (95% CI, 1.6–10.0), versus 2.4 months (95% CI, 1.5–3.3; p = .04) for best supportive care. Conclusion: Brain metastases in low-grade EC is rare, prognosis generally poor. Compared to supportive care only, any treatment results in more favorable outcomes. Keywords: Brain metastases, Endometrial carcinoma, Low-grade endometrial carcinoma