CNS metastasis worsens survival in endometrial cancer

Among patients with endometrial cancer (EC), central nervous system metastasis (CNSm) is strongly associated with poor prognoses and survival outcomes, a recent study has found.

Researchers conducted a retrospective analysis of 22 EC patients with CNSm and 354 controls without CNSm. Most patients had advanced stage disease and high-grade tumours, while 27.2 percent had high-risk histology.

At the time of diagnosis, those with CNSm were significantly younger than controls (mean, 58.2 vs 62.0 years, p=0.018). They also had lower body mass index (p=0.005) and were more likely to present with high-grade tumours (p≤0.001) and a serous cancer histology (p=0.01).

Median survival in the CNSm cohort was 49 months, but this dropped to 9 months after CNSm diagnosis. After controlling for potential confounders, Cox proportional hazards regression analysis revealed that CNSm significantly increased the risk of death by nearly fivefold (hazard ratio [HR], 4.96; p=0.022).

Of note, patients who underwent surgical resection for their CNSm showed significantly longer median overall survival (83 vs 33 month; p=0.003), as did those who received multimodal treatments for CNSm, regardless of the combination of modalities (83 vs 33 months; p=0.027).

In contrast, whole-brain radiation therapy for CNSm significantly reduced survival (23 vs 83 months; p=0.014).

“Additional molecular profiling of these tumours may allow for elucidation of a mechanism behind the propensity for CNS metastasis in order to aid in early diagnosis and potentially prevention in patients at risk,” the researchers said.