DISP-04. Racial Disparities in Brain Metastasis and Survival Among Patients with Gynecologic Cancers

INTRODUCTION Brain metastases originating from gynecologic cancers are rare, and the influence of race on their incidence, management, and outcomes remains poorly defined. While disparities in oncologic care are well documented, few studies have explored racial differences in the context of uncommon metastatic events and their associated survival outcomes. Objectives: 1. Evaluate the incidence of brain metastases among patients with varying gynecologic cancers, stratified by race. 2. Compare overall survival following brain metastasis in propensity-matched cohorts of ovarian cancer patients. METHODS We conducted a retrospective cohort study using TriNetX, a multicenter federated health research network, to identify adult female patients diagnosed with primary gynecologic cancers, including malignancies of the cervix, corpus uteri, uterus not otherwise specified, and ovary. Patients were stratified by race (Black vs. White) and matched using propensity scores for age, age at index diagnosis, and ethnicity. The primary outcome was the incidence of brain metastases (ICD-10-CM: C79.3, C79.31, C79.32). Secondary outcomes included overall survival at 3 years following metastasis from primary ovarian cancer. Kaplan-Meier survival analysis was conducted for these patients. RESULTS A total of 54,004 patients were included across matched Black and White cohorts spanning four primary gynecologic cancer types. The incidence of brain metastases remained low (<1.2%) across all subtypes, with no statistically significant racial differences observed. Among ovarian cancer patients, brain metastases occurred in 0.82% of Black patients and 0.89% of White patients (p = 0.6936). Three-year survival following brain metastasis from ovarian cancer was similar between Black (41.35%) and White (47.56%) patients (p = 0.8734). CONCLUSION In this large, multi-institutional analysis, no statistically significant racial disparities were found in the incidence of brain metastases or survival outcomes among gynecologic cancer patients. Larger datasets are needed to further evaluate disparities in rare metastatic presentations.