Leptomeningeal metastasis after surgical resection of brain metastases
OBJECTIVE: To determine the incidence and risk factors for leptomeningeal metastasis after surgery for brain metastasis of solid tumors. METHODS: Review of the records of all patients operated on for brain metastasis between January 1990 and August 1995. RESULTS: In this period 28 patients underwent surgery for brain metastasis, of whom 27 were available for evaluation in this study. Median survival after craniotomy was 11 months. Nine patients (33%) developed leptomeningeal metastasis 2-13 months after surgery, which included six of the nine patients operated on for posterior fossa metastasis (p=0.05). In five patients, leptomeningeal metastasis was the only site of recurrence. Three patients developed the leptomeningeal metastasis as bulky tumour along the spinal cord, which is a rare presentation. No other risk factors for the development of leptomeningeal metastasis other than surgery for posterior fossa metastasis were identified. CONCLUSIONS: There is an increased risk of leptomeningeal metastasis after surgery for posterior fossa metastasis. Future trials should consider the value of an active approach to this complication in these patients.
|Adult, Aged, Brain Neoplasms/mortality/*secondary/surgery, Female, Humans, Magnetic Resonance Imaging, Male, Meningeal Neoplasms/mortality/pathology/*secondary, Middle Aged, Survival Analysis|
|Journal of Neurology, Neurosurgery and Psychiatry: an international peer-reviewed journal for health professionals and researchers in all areas of neurology and neurosurgery|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
van der Ree, T.C, Dippel, D.W.J, Avezaat, C.J.J, Vecht, C.J, van den Bent, M.J, & Sillevis Smitt, P.A.E. (1999). Leptomeningeal metastasis after surgical resection of brain metastases. Journal of Neurology, Neurosurgery and Psychiatry: an international peer-reviewed journal for health professionals and researchers in all areas of neurology and neurosurgery. Retrieved from http://hdl.handle.net/1765/9057