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Leptomeningeal disease in neurosurgical brain metastases patients: A systematic review and meta-analysis.


ABSTRACT:

Background

Leptomeningeal disease (LMD) is a complication distinguished by progression of metastatic disease into the leptomeninges and subsequent spread via cerebrospinal fluid (CSF). Although treatments for LMD exist, it is considered fatal with a median survival of 2-4 months. A broader overview of the risk factors that increase the brain metastasis (BM) patient's risk of LMD is needed. This meta-analysis aimed to systematically review and quantitatively assess risk factors for LMD after surgical resection for BM.

Methods

A systematic literature search was performed on 7 May 2021. Pooled effect sizes were calculated using a random-effects model for variables reported by three or more studies.

Results

Among 503 studies, thirteen studies met the inclusion criteria with a total surgical sample size of 2105 patients, of which 386 patients developed LMD. The median incidence of LMD across included studies was 16.1%. Eighteen unique risk factors were reported as significantly associated with LMD occurrence, including but not limited to: larger tumor size, infratentorial BM location, proximity of BM to cerebrospinal fluid spaces, ventricle violation during surgery, subtotal or piecemeal resection, and postoperative stereotactic radiosurgery. Pooled results demonstrated that breast cancer as the primary tumor location (HR = 2.73, 95% CI: 2.12-3.52) and multiple BMs (HR = 1.37, 95% CI: 1.18-1.58) were significantly associated with a higher risk of LMD occurrence.

Conclusion

Breast cancer origin and multiple BMs increase the risk of LMD occurrence after neurosurgery. Several other risk factors which might play a role in LMD development were also identified.

SUBMITTER: Tewarie IA 

PROVIDER: S-EPMC8633671 | biostudies-literature | 2021 Jan-Dec

REPOSITORIES: biostudies-literature

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Leptomeningeal disease in neurosurgical brain metastases patients: A systematic review and meta-analysis.

Tewarie Ishaan Ashwini IA   Jessurun Charissa A C CAC   Hulsbergen Alexander F C AFC   Smith Timothy R TR   Mekary Rania A RA   Broekman Marike L D MLD   Broekman Marike L D MLD  

Neuro-oncology advances 20210101 1


<h4>Background</h4>Leptomeningeal disease (LMD) is a complication distinguished by progression of metastatic disease into the leptomeninges and subsequent spread via cerebrospinal fluid (CSF). Although treatments for LMD exist, it is considered fatal with a median survival of 2-4 months. A broader overview of the risk factors that increase the brain metastasis (BM) patient's risk of LMD is needed. This meta-analysis aimed to systematically review and quantitatively assess risk factors for LMD af  ...[more]

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