Assessment of Leptomeningeal Carcinomatosis Diagnosis, Management and Outcomes in Patients with Solid Tumors Over a Decade of Experience.
Leptomeningeal carcinomatosis
breast cancer
cerebrospinal fluid
magnetic resonance imaging
metastasis
Journal
European journal of breast health
ISSN: 2587-0831
Titre abrégé: Eur J Breast Health
Pays: Turkey
ID NLM: 101709357
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
27
04
2021
accepted:
18
07
2021
entrez:
15
10
2021
pubmed:
16
10
2021
medline:
16
10
2021
Statut:
epublish
Résumé
Leptomeningeal carcinomatosis (LMC), a common complication of advanced malignancies, is associated with high morbidity and mortality, yet diagnosis and treatment decisions remain challenging. This study describes the diagnostic and treatment modalities for LMC and identifies factors associated with overall survival (OS). We performed a single-institution retrospective study (registration #: OSU2016C0053) of 153 patients diagnosed with LMC treated at The Ohio State University, Comprehensive Cancer Center, (OSUCCC)-James between January 1, 2010 and December 31, 2015. Median age at diagnosis was 55.7 years, and 61% had Eastern Cooperative Oncology Group baseline performance status ≤1. Most common primary tumors were breast (43%), lung (26%), and cutaneous melanoma (10%). At presentation, most patients were stage III-IV (71%) with higher grade tumors (grade III: 46%). Metastases to bone (36%), brain (33%), and lung (12%) were the most common sites with a median of 0.5 years (range, 0-14.9 years) between the diagnosis of first metastasis and of LMC. 153 (100%) patients had MRI evidence of LMC. Of the 67 (44%) who underwent lumbar puncture (LP), 33 (22%) had positive cerebrospinal fluid (CSF) cytology. Most patients received radiotherapy for LMC (60%) and chemotherapy (93%) for either the primary disease or LMC. 28 patients received intrathecal chemotherapy, 22 of whom had a primary diagnosis of breast cancer. 98% died with median OS of all patients was 1.9 months (95% CI: 1.3-2.5 months). Despite improved treatments and targeted therapies, outcomes of LMC remain extremely poor. Positive CSF cytology was associated with lower OS in patients who had cytology assessed and specifically in patients with breast cancer. CSF cytology serves as an important indicator for prognosis and helps aid in developing individualized therapeutic strategies for patients with LMC.
Identifiants
pubmed: 34651117
doi: 10.4274/ejbh.galenos.2021.2021-4-10
pii: 49047
pmc: PMC8496125
doi:
Types de publication
Journal Article
Langues
eng
Pagination
371-377Informations de copyright
©Copyright 2021 by Turkish Federation of Breast Diseases Associations.
Déclaration de conflit d'intérêts
Conflict of Interest: No conflict of interest was declared by the authors.
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Semin Neurol. 2010 Jul;30(3):236-44
pubmed: 20577930
Cancer. 1978 Jul;42(1):283-6
pubmed: 667799
Cancer. 1973 Mar;31(3):520-33
pubmed: 4511909
Postgrad Med J. 1980 Mar;56(653):149-58
pubmed: 7393804
Neurology. 2010 May 4;74(18):1449-54
pubmed: 20439847
Eur J Drug Metab Pharmacokinet. 2019 Dec;44(6):845-851
pubmed: 31435852
Ann Oncol. 2016 Jun;27(6):1138-1142
pubmed: 26961150
Neurology. 1991 Nov;41(11):1765-9
pubmed: 1944906
Ann Neurol. 1985 Jan;17(1):100-2
pubmed: 3985577
J Neurooncol. 1998 May;37(3):271-84
pubmed: 9524085
Cancer Treat Rev. 2016 Feb;43:83-91
pubmed: 26827696
Am J Med. 1982 Nov;73(5):641-7
pubmed: 6814249
J Cancer Res Clin Oncol. 2010 Nov;136(11):1729-35
pubmed: 20204406
Am J Cancer Res. 2013 Apr 03;3(2):117-26
pubmed: 23593536
J Neurooncol. 1990 Dec;9(3):225-9
pubmed: 2086737
Ann Neurol. 1980 Dec;8(6):605-8
pubmed: 6260012
J Clin Oncol. 2005 May 20;23(15):3605-13
pubmed: 15908671
J Neurooncol. 1997 Oct;35(1):55-64
pubmed: 9266441
Lancet Oncol. 2010 Sep;11(9):871-9
pubmed: 20598636
Ann Neurol. 1995 Jul;38(1):51-7
pubmed: 7611725
Neurosurg Clin N Am. 2011 Jan;22(1):67-78, vii
pubmed: 21109151
J Neurol Sci. 2004 Aug 30;223(2):167-78
pubmed: 15337619
Arch Neurol. 2010 Mar;67(3):305-12
pubmed: 20212228
Strahlenther Onkol. 2001 Apr;177(4):195-9
pubmed: 11370554
Cancer. 1978 Feb;41(2):776-83
pubmed: 630551
Neurol Clin. 2003 Feb;21(1):25-66
pubmed: 12690644
J Neurooncol. 2009 Jun;93(2):205-12
pubmed: 19043775
Ann Oncol. 2017 Jul 1;28(suppl_4):iv84-iv99
pubmed: 28881917
Cancer. 1979 Nov;44(5):1885-93
pubmed: 227582
J Comput Assist Tomogr. 1990 Mar-Apr;14(2):255-61
pubmed: 2312855
Am J Med. 1981 Jul;71(1):26-32
pubmed: 6264785
Curr Treat Options Neurol. 2012 Aug;14(4):402-15
pubmed: 22736147