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Leptomeningeal metastases in glioma: The Memorial Sloan Kettering Cancer Center experience.

TitleLeptomeningeal metastases in glioma: The Memorial Sloan Kettering Cancer Center experience.
Publication TypeJournal Article
Year of Publication2019
AuthorsAndersen BM, Miranda C, Hatzoglou V, DeAngelis LM, Miller AM
JournalNeurology
Volume92
Issue21
Paginatione2483-e2491
Date Published2019 05 21
ISSN1526-632X
KeywordsAdult, Aged, Aged, 80 and over, Astrocytoma, Brain Neoplasms, Female, Glioblastoma, Glioma, Humans, Incidence, Male, Meningeal Neoplasms, Middle Aged, Oligodendroglioma, Prognosis, Retrospective Studies, Survival Rate, Young Adult
Abstract

OBJECTIVE: To perform a retrospective analysis examining the incidence and prognosis of glioma patients with leptomeningeal disease (LMD) at Memorial Sloan Kettering Cancer Center over a 15-year period and correlate these findings with clinicopathologic characteristics.

METHODS: We conducted a retrospective review of glioma patients with LMD at Memorial Sloan Kettering Cancer Center diagnosed from 2001 to 2016. Patients were identified through a keyword search of their electronic medical record and by ICD-9 codes.

RESULTS: One hundred three patients were identified with disseminated LMD and 85 patients with subependymal spread of disease, 4.7% of all patients with glioma. These cohorts were analyzed separately for time to development of disseminated LMD/subependymal LMD, median overall survival, and survival from LMD diagnosis. Patients were pooled for subsequent analyses (n = 188) because of comparable clinical behavior. LMD was present at glioma diagnosis in 10% of patients. In the remaining 90% of patients diagnosed at recurrence, time to LMD diagnosis, survival after LMD diagnosis, and overall survival varied by original histology. Patients with oligodendroglioma had a median survival of 10.8 (range 1.8-67.7) months, astrocytoma 6.5 (0.1-28.5) months, and glioblastoma 3.8 (0.1-32.6) months after LMD diagnosis. In addition, we found that treatment of LMD was associated with superior performance status and increased survival.

CONCLUSION: Patients with LMD diagnosed at relapse may not have decreased overall survival as compared to historical controls with parenchymal relapse and may benefit from treatment.

DOI10.1212/WNL.0000000000007529
Alternate JournalNeurology
PubMed ID31019097
PubMed Central IDPMC6541431
Grant ListP30 CA008748 / CA / NCI NIH HHS / United States

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