Incidence and risk factors for the development of cerebral metastasis in cervical cancer patients

Abstract

Objective Cerebral metastasis (CM) in cervical cancer (CC) cases, although rare, results in high lethality rates. The present study aimed to assess CM incidence in a Brazilian reference CC center and evaluate the risk factors for CM development. Retrospective observational study of patients diagnosed with CC between 2010 and 2017. Methods Cumulative CM incidence and incidence density were evaluated. Characteristics associated to CM development risks were identified using crude (cOR) or adjusted (aOR) odds ratios. Results A total of 3,397 patients were included in this study. Patient age ranged from 18 to 101 years, with a mean age of 48.8±14.0. After a mean follow-up time of 3.2±2.1 years, 51 CM cases were identified, resulting in a cumulative incidence of 1.5% (95% confidence intervals [CI]=1.12–1.97) and an incidence density at the end of the 6th year of 27.4 per 1,000 women/year. Advanced clinical stage (aOR=3.15; 95% CI=1.16–8.58; p=0.025), the presence of previous lung metastasis (aOR=4.04; 95% CI=1.82–8.94; p=0.001) and the adenocarcinoma (aOR=2.90; 95% CI=1.46–5.76; p=0.002), adenosquamous carcinoma (aOR=7.33; 95% CI=2.87–18.73; p<0.001), undifferentiated carcinoma (aOR=14.37; 95% CI=3.77–54.76; p<0.001) and neuroendocrine carcinoma (aOR=21.31; 95% CI=6.65–68.37, p<0.001) histological types were associated with a higher risk for CM development. CM risk was higher in the first years of follow-up, with no cases observed after the 6th year. Conclusion CC patients in advanced clinical stages, displaying previous lung metastasis and non-squamous histological types are at high risk of developing CM.