Breaking the survival barriers: A case of stage IV carcinoma ovary with brain metastasis

2020 ◽  
Vol 9 (3) ◽  
pp. 92
Author(s):  
Shabnum Thakur ◽  
Lalit Chandrakant ◽  
Vikas Fotedar ◽  
Manish Gupta
Keyword(s):  
Brain Metastasis ◽  
Stage Iv ◽  
Carcinoma Ovary

scholarly journals Alpha-Fetoprotein-Producing Lung Hepatoid Adenocarcinoma with Brain Metastasis Treated with S-1

2020 ◽  
Vol 13 (3) ◽  
pp. 1552-1559
Author(s):  
Yuki Muroyama ◽  
Hiroyuki Tamiya ◽  
Goh Tanaka ◽  
Wakae Tanaka ◽  
Alexander C. Huang ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Disease Control ◽  
Parietal Lobe ◽  
Laboratory Data ◽  
Stage Iv ◽  
Final Diagnosis ◽  
Alpha Fetoprotein ◽  
Hepatoid Adenocarcinoma ◽  
Clinical Prognosis

Lung hepatoid adenocarcinoma (HAC) is a rare primary lung carcinoma pathologically characterized by hepatocellular carcinoma-like tumor cells, the majority of which produce alpha-fetoprotein (AFP). The clinical prognosis of lung HAC is generally poor, and effective therapeutic regimens for inoperable or recurrent cases have not been established. Here, we report a case of AFP-producing lung HAC with brain metastasis with long-term disease control, treated with the 5-fluorouracil-derived regimen S-1. The patient was a 66-year-old male admitted to the hospital with alexia. Chest X-ray revealed a massive tumor in the left upper lobe, and a head CT scan revealed a metastasis in the left parietal lobe. The laboratory data showed a remarkably elevated AFP level (97,561 ng/mL). Pathological assessment of the resected brain tumor revealed HAC, which was compatible with the lung biopsies. Together with the absence of other metastatic lesions, a final diagnosis of primary lung HAC, stage IV T4N3M1b, was given. The patient first underwent non-small cell lung cancer chemotherapy regimens (carboplatin and paclitaxel as the first line, and pemetrexed as the second line), but had clinical progression. After third-line oral S-1 (tegafur/gimeracil/oteracil) administration, the serum AFP level significantly dropped and the patient achieved long-term disease control without relapse, surviving more than 19 months after disease presentation. The autopsy result was consistent with the diagnosis of primary lung HAC, and immunohistochemical staining was AFP+, glypican 3+, and spalt-like transcription factor 4+. Here, we report the case of a rare primary lung HAC with apparent disease control on S-1 therapy, together with a literature review.

Prognostic factors and survival after whole-brain radiotherapy for initial brain metastases arising from non-small cell lung cancer

2021 ◽  
pp. 1-6
Author(s):  
Yukinori Okada ◽  
Mariko Kobayashi ◽  
Mio Shinozaki ◽  
Tatsuyuki Abe ◽  
Naoki Nakamura
Keyword(s):  
Prognostic Factors ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Gene Mutation ◽  
Stage Iv ◽  
Whole Brain Radiotherapy ◽  
Hazard Ratio ◽  
Small Cell Lung ◽  
Mutation Status ◽  
Brain Radiotherapy

Abstract Aim: To identify prognostic factors and investigate patient survival after whole-brain radiotherapy (WBRT) for initial brain metastases arising from non-small cell lung cancer (NSCLC). Methods: Patients diagnosed with NSCLC between 1 January 2010 and 30 September 2019, and who received WBRT upon first developing a brain metastasis, were investigated. Overall survival was determined as related to age, sex, duration between initial examination and brain metastasis detection, stage at the first examination, presence of metastases outside the brain, blood analysis findings, brain metastasis symptoms, radiotherapy dose and completion, imaging findings, therapeutic course of chemotherapy and/or radiation therapy, histological type, and gene mutation status. Results: Thirty-one consecutive patients (20 men and 11 women) with a mean age of 63·8 years and median survival of 129 days were included. Multivariate analysis with stepwise testing was performed to investigate differences in survival according to gene mutation status, lactate dehydrogenase (LDH) level, irradiation dose, WBRT completion and Stage status. Of these, a statistically significant difference in survival was observed in patients with gene mutation status (hazard ratio: 0·31, 95% CI: 0·11–0·86, p = 0·025), LDH levels <230 vs. ≥230 IU/L (hazard ratio: 4·08, 95% CI: 1·45–11·5, p < 0·01) received 30 Gy, 30 Gy/10 fractions to 35 Gy/14 fractions, and 37·5 Gy/15 fractions (hazard ratio: 0·26, 95% CI: 0·09–0·71, p < 0·01), and stage IV versus non-stage IV (hazard ratio: 0·13, 95 CI:0·02–0·64, p < 0·01) Findings: Gene mutation, LDH, radiation dose and Stage are prognostic factors for patients with initial brain metastases who are treated with WBRT.

scholarly journals Brain Metastasis in Papillary Serous Adenocarcinoma of the Endometrium

2019 ◽  
Vol 41 (04) ◽  
pp. 264-267
Author(s):  
Walberto Eulálio Filho ◽  
Taíla Fé ◽  
Rodolfo Rodrigues ◽  
Maria Lima ◽  
Sabas Vieira
Keyword(s):  
Brain Metastasis ◽  
Parietal Lobe ◽  
Brain Magnetic Resonance Imaging ◽  
Stage Iv ◽  
Rare Condition ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Serous Adenocarcinoma ◽  
Surgical Specimen ◽  
The Brain

Background Most endometrial cancers (75%) are diagnosed in early stages (stages I and II), in which abnormal uterine bleeding is the most frequent clinical sign. When the diagnosis is performed in stage IV, the most common sites of metastasis are the lungs, liver and bones. Central nervous system (CNS) metastasis is a rare condition. The aim of this study is to describe a case of uterine papillary serous adenocarcinoma of the endometrium that progressed to brain and bone metastases. Case Report We present the case of a 56-year-old woman with abnormal uterine bleeding and endometrial thickened echo (1.8 cm). A hysteroscopy with biopsy was performed, which identified poor differentiated serous adenocarcinoma of the endometrium. A total abdominal hysterectomy, with pelvic and para-aortic lymphadenectomy, was performed. Analysis of the surgical specimen revealed a grade III uterine papillary serous adenocarcinoma. Adjuvant radio/chemotherapy (carboplatin and paclitaxel—six cycles) was indicated. Sixteen months after the surgery, the patient began to complain of headaches. Brain magnetic resonance imaging demonstrated an expansile mass in the right parietal lobe, suggesting a secondary hematogenous implant subsequently confirmed by biopsy. She underwent surgery for treatment of brain metastasis, followed by radiotherapy. She died 12 months after the brain metastasis diagnosis due to disease progression. Conclusion Uterine papillary serous adenocarcinoma of the endometrium has a low propensity to metastasize to the brain. To the best of our knowledge, this is the fifth documented case of uterine papillary serous adenocarcinoma of the endometrium with metastasis to the CNS.

scholarly journals The Clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ru Wang ◽  
Yayun Zhu ◽  
Xiaoxu Liu ◽  
Xiaoqin Liao ◽  
Jianjun He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Stage Iv ◽  
Clinicopathological Features ◽  
Breast Cancer Patients ◽  
Kaplan Meier ◽  
Stage Iv Breast Cancer ◽  
Multivariable Analyses ◽  
Metastatic Sites

Abstract Background The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites. Methods Using the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi-square tests. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan-Meier method with log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors. Results A total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan-Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS (p < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors. Conclusion Stage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.

Reduction of Brain Metastasis Following Immunotherapy with Interleukin-2 for Stage IV Renal Cell Cancer

1997 ◽  
Vol 36 (2) ◽  
pp. 228-228 ◽  
Author(s):  
Giovanni Citterio ◽  
Giuseppe Di Lucca ◽  
Ugo Scaglietti ◽  
Sara Gilberti ◽  
Monica Baldini ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Cell Cancer ◽  
Interleukin 2 ◽  
Stage Iv

Frequency of radiologically confirmed brain metastasis from time of diagnosis of stage IV disease in patients with melanoma.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e19012-e19012
Author(s):  
R. Noor ◽  
C. Wei ◽  
N. E. Papadopoulos ◽  
K. B. Kim ◽  
W. Hwu ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Stage Iv ◽  
Stage Iv Disease

Surgical management associates independently with improved survival among de novo stage IV breast cancer patients without liver or brain metastasis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12106-e12106
Author(s):  
Cuizhi Geng ◽  
Wenjin Zhang ◽  
Zhensheng Li
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Brain Metastasis ◽  
Surgical Management ◽  
Median Survival ◽  
De Novo ◽  
Stage Iv ◽  
Surgical Patients ◽  
Axillary Lymph ◽  
Stage Iv Breast Cancer

e12106 Background: To examine the independent effect of surgical management of the primary tumor and axillary lymph node on survival in patients with de novo Stage IV breast cancer (BC) Methods: 113 patients with de novo stage BC between 2010 to 2013 were followed up to Oct. 1, 2016. Multivariable Cox proportional hazard models were constructed to assess the effect of mastectomy (MAS) and axillary lymph node dissection (ALND) on overall survival (OS) after univariate analyses and K-M curves. Non-treatment covariates included age, BMI, menopause, Stage T, Stage N, ER, PR, HER2, Ki67>14% status, and metastasis sites (lung, liver, bone, brain and others). Chemotherapy, hormonal, target treatement and radiotherapy before the disease progression were others. Results: Mean age 52 (24 - 84) years old, metastasis site by bone 53% (60), lung 32% (36), liver 32% (36), brain 2% (2), and other 23% (23). Median survival 21.4 months. All 42% (48) surgical patients had simultaneous MAS and ALND. Younger (mean 49 vs. 54) and fewer post-menopause (42% vs. 62%) were significantly noticed in surgical patients with median survival 37.8 vs. 14.2 months of others. Multivariable analysis showed OS favorable HRs 0.53 (95% CI 0.24 - 1.17, p=0.12) of surgery and HR 0.48 (0.22 - 1.04, p=0.06) of hormonal drug, and significant HR 0.10, (0.02 - 0.52, p<0.01) of target therapy, insignificant effects of chemotherapy HR 0.60(0.26 - 1.42, p=0.25) and radiotherapy HR 0.70 (0.33 - 1.50, p =0.36). Unfavorable metastasis sites were identified as brain and liver at multivariable model for subgroup analysis. K-M curves estimated median survival 29.3 vs. 14.4 months (favorable vs. unfavorable patients). Both univariate and multivariate analyses showed the significant effect of surgery in favorable subgroup (N=76) with HR 0.30 (0.16 - 0.56, p <0.01) and 0.33 (0.11 - 0.98, p=0.05) on OS, respectively. In unfavorable subgroup (N=37), the results were insignificant effect of surgery on OS with HR 0.75 (0.37 - 1.55, p=0.54) and 1.60 (0.33 - 7.81, p=0.56). Conclusions: Surgical management associated independently with improved survival among de novo stage IV BC patients without liver or brain metastasis.

scholarly journals The Clinicopathological Features and Survival Outcomes of Patients with Different Metastatic Sites in Stage IV Breast Cancer

2019 ◽  
Author(s):  
Ru Wang ◽  
Yayun Zhu ◽  
Xiaoxu Liu ◽  
Xiaoqin Liao ◽  
Jianjun He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Stage Iv ◽  
Clinicopathological Features ◽  
Breast Cancer Patients ◽  
Kaplan Meier ◽  
Stage Iv Breast Cancer ◽  
Multivariable Analyses ◽  
Metastatic Sites

Abstract Background The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites. Methods Using the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi‐square tests. Breast cancer‐specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan‐Meier method with log‐rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors. Results A total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan‐Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS ( p < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors. Conclusion Stage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.

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