ArticleNeuro-oncology2021
Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors.
Article in Neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 81 papers, 3 of them syntheses that pooled it.
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Who cites it
81 citing papers in PubMed, 3 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- 6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).Breast (Edinburgh, Scotland) · 2024Guideline
- Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.ESMO open · 2023Guideline
- Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions.Neuro-oncology · 2022Guideline
- Trial
- Phase II study of intrathecal administration of trastuzumab in patients with HER2-positive breast cancer with leptomeningeal metastasis.Neuro-oncology · 2023Trial
- Randomized Phase II Trial of Proton Craniospinal Irradiation Versus Photon Involved-Field Radiotherapy for Patients With Solid Tumor Leptomeningeal Metastasis.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- Characterizing intradural spinal metastasis in the metastatic cascade: clinical course, dissemination timing, and molecular features in 69 patients.Journal of neuro-oncology · 2026Article
- Article
- Article
- Clinical and CSF Measurements for Identification of Leptomeningeal Metastasis in Lung Adenocarcinoma.Diagnostics (Basel, Switzerland) · 2026Article
- Review
- Intrathecal nivolumab in metastatic solid tumors with leptomeningeal disease: dose escalation part of the multicenter IT-PD1/NOA-26 phase 1 trial.Nature cancer · 2026Article
- Survival outcomes and a prognostic nomogram in EGFR-mutant non-small cell lung cancer with leptomeningeal metastasis: a real-world cohort study.Journal of neuro-oncology · 2026Article
- Evaluation of cerebrospinal fluid human epididymis protein 4 for leptomeningeal metastasis in non-small cell lung cancer: a prospective cohort study.BMC cancer · 2026Article
- Significance of Positive Cerebrospinal Fluid Cytology (Leptomeningeal Metastasis) in Central Nervous System Metastasis - A Multicentre Clinicopathological Review.Pathology international · 2026Article
- Identifying Prognostic Factors in Brain Metastasis Patients Using MRI Morphological Features: A Machine Learning and Survival Analysis Approach.Diagnostics (Basel, Switzerland) · 2026Article
- Melanoma leptomeningeal disease: Advances in diagnosis and emerging therapeutic strategies.World journal of experimental medicine · 2026Review
- [Chinese Expert Consensus on Clinical Management of Oncogene Addicted Non-small Cell Lung Cancer with Leptomeningeal Metastasis (2026 Edition)].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Article
- Leptomeningeal metastatic disease responding to carboplatin, pemetrexed, and amivantamab after progression to osimertinib in EGFR exon 21 L858R-Mutated non-small cell lung cancer: Two case reports.Respiratory medicine case reports · 2026Article
- The evolving landscape of leptomeningeal metastases from NSCLC: an international, contemporary, multicenter cohort study.Annals of oncology : official journal of the European Society for Medical Oncology · 2026Article
21 more citing papers are in PubMed but not listed here.
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Authors and funding
15 authors at 8 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe EANO ESMO guidelines have proposed a classification of leptomeningeal metastases (LM) from solid cancers based on clinical, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) cytology presentation. MRI patterns are classified as linear, nodular, both, or neither. Type I LM is defined by positive CSF cytology (confirmed LM) whereas type II LM is defined by typical clinical and MRI signs (probable or possible LM). Here we explored the clinical utility of these LM subtypes. PATIENTS AND
methodsWe retrospectively assembled data from 254 patients with newly diagnosed LM from solid tumors. Survival curves were derived using the Kaplan-Meier method and compared by Log-rank test.
resultsMedian age at LM diagnosis was 56 years. Typical clinical LM features were noted in 225 patients (89%); 13 patients (5%) were clinically asymptomatic. Tumor cells in the CSF were observed in 186 patients (73%) whereas the CSF was equivocal in 24 patients (9.5%) and negative in 44 patients (17.5%). Patients with confirmed LM had inferior outcome compared with patients with probable or possible LM (P = 0.006). Type I patients had inferior outcome than type II patients (P = 0.002). Nodular disease on MRI was a negative prognostic factor in type II LM (P = 0.014), but not in type I LM. Administration of either intrathecal pharmacotherapy (P = 0.020) or systemic pharmacotherapy (P = 0.0004) was associated with improved outcome in type I LM, but not in type II LM.
conclusionThe EANO ESMO LM subtypes are highly prognostic and should be considered for stratification and overall design of clinical trials.
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