31P Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study

The purpose of this study was to evaluate the risk and prognostic factors of stage IVB cervical cancer with brain metastasis from the Surveillance, Epidemiology and End Results (SEER) population-based database. Cervical cancer patients initially diagnosed with brain metastasis between 2010-2019 were included in this study. The risk factors of developing brain metastasis were evaluated by logistic regression model with corresponding 95% confidence interval (95% CI). Survival analysis was performed through the Kaplan–Meier method, log-rank test, and Cox proportional hazards model. A total of 88 (88/25476, 0.35%) cervical cancer patients initially diagnosed with brain metastasis between 2010-2019 were retrieved. The presence of lung, bone or liver metastasis (all P<0.001) were shown to be independent risk factors for developing brain metastasis. Patients with brain metastasis showed a poor prognosis (P<0.001, HR=2.84, 95%CI=1.71-4.72) with a median survival of 6 months, which is much shorter than with the lung (9 months), liver (8.5 months) or bone (11 months) metastasis groups. Patients with lower tumor grade (P=0.001, HR=0.27, 95% CI=0.09-0.76) and with bone metastasis (P=0.007, HR=2.74, 95% CI=1.33-5.67) also demonstrated poor overall survival outcomes in patients with brain metastasis. In terms of treatment modality, chemoradiotherapy tended to prolong the survival of stage IVB cervical cancer patients with brain metastasis (P=0.001, HR=0.17 95%CI=0.06-0.48). In conclusion, the prognosis of stage IVB cervical cancer patients with brain metastasis remains poor. Chemoradiotherapy may provide survival benefits, which deserves large scale prospective clinical trials to confirm.