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

Neurology. 2019 May 21;92(21):e2483-e2491. doi: 10.1212/WNL.0000000000007529. Epub 2019 Apr 24.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Astrocytoma / epidemiology
  • Astrocytoma / secondary
  • Brain Neoplasms / pathology*
  • Female
  • Glioblastoma / epidemiology
  • Glioblastoma / secondary
  • Glioma / epidemiology
  • Glioma / secondary*
  • Glioma / therapy
  • Humans
  • Incidence
  • Male
  • Meningeal Neoplasms / epidemiology
  • Meningeal Neoplasms / secondary*
  • Meningeal Neoplasms / therapy
  • Middle Aged
  • Oligodendroglioma / epidemiology
  • Oligodendroglioma / secondary
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Young Adult