ArticleJournal of neuro-oncology2021
Cerebrospinal fluid diversion for leptomeningeal metastasis: palliative, procedural and oncologic outcomes.
Article in Journal of neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.ESMO open · 2023Guideline
- Postoperative course of cerebrospinal fluid diversion in the setting of leptomeningeal disease: a systematic review, meta-analysis, and meta-regression with an illustrative case.Journal of neuro-oncology · 2023Pooled it
- Lumbar-ventricular cerebrospinal fluid pressure discrepancy in leptomeningeal metastasis associated intracranial hypertension.Fluids and barriers of the CNS · 2026Article
- Melanoma leptomeningeal disease: Advances in diagnosis and emerging therapeutic strategies.World journal of experimental medicine · 2026Review
- Integrative Analysis of Clinical Features and Cerebrospinal Fluid Immune Microenvironment in Leptomeningeal Metastasis From Non-small-cell Lung Cancer Patients.Clinical Medicine Insights. Oncology · 2026Article
- Predictive factors for clinical outcome of palliative ventriculoperitoneal shunt in the treatment of leptomeningeal metastasis.Translational cancer research · 2025Article
- Managing hydrocephalus in patients with leptomeningeal disease: A multicenter retrospective analysis.International journal of cancer · 2025Article
- Local cranial radiation combined with third-generation tyrosine kinase inhibitors improve leptomeningeal metastasis disease-free survival in patients with EGFR-mutated non-small cell lung cancer and brain metastasis.Journal of neuro-oncology · 2025Article
- A hitchhiker's guide to cerebrospinal fluid biomarkers for neuro-oncology.Neuro-oncology · 2025Review
- Leptomeningeal Disease: Current Approaches and Future Directions.Current neurology and neuroscience reports · 2025Review
- The research progress on meningeal metastasis in solid tumors.Discover oncology · 2025Review
- Article
- Integration of continuous lumbar drainage and third-generation EGFR-TKI in managing leptomeningeal metastasis-induced life-threatening intracranial hypertension: a case report.Frontiers in oncology · 2025Article
- Different methods of cerebrospinal fluid diversion in patients with leptomeningeal metastasis: A systematic review and meta-analysis.Surgical neurology international · 2025Review
- Leptomeningeal metastases from solid tumors: A Society for Neuro-Oncology and American Society of Clinical Oncology consensus review on clinical management and future directions.Neuro-oncology · 2024Review
- The Spectrum of Headache in Leptomeningeal Metastases: A Comprehensive Review with Clinical Management Guidelines.Current pain and headache reports · 2023Review
- Brain metastasis and intracranial leptomeningeal metastasis from malignant peripheral nerve sheath tumors: illustrative cases.Journal of neurosurgery. Case lessons · 2023Article
- Review
- Leptomeningeal Metastases: New Opportunities in the Modern Era.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundLeptomeningeal metastasis (LM) occurs in 3-5% of patients with solid metastatic tumors and often portends a severe prognosis including symptomatic hydrocephalus and intracranial hypertension. Cerebrospinal fluid (CSF) shunting can provide symptomatic relief in this patient subset; however, few studies have examined the role of shunting in the palliation, prognosis and overall oncologic care of these patients.
objectiveTo identify and evaluate risk factors associated with prognosis after CSF diversion and assess surgical, symptomatic and oncologic outcomes in this population.
methodsA retrospective study was conducted on patients with solid-malignancy LM treated with a shunt at a NCI-designated Comprehensive Cancer Center between 2010 and 2019.
resultsOne hundred and ninety patients with metastatic LM underwent CSF diversion. Overall survival was 4.14 months from LM diagnosis (95% CI: 3.29-4.70) and 2.43 months (95% CI: 2.01-3.09) from shunting. Karnofsky performance status (KPS) at time of shunting and brain metastases (BrM) number at LM diagnosis demonstrated significant associations with survival (HR = 0.66; 95% CI [0.51-0.86], p = 0.002; HR = 1.40; 95% CI [1.01-1.93] per 10 BrM, p = 0.04, respectively). Eighty-three percent of patients experienced symptomatic relief, and 79% were discharged home or to rehabilitation facilities post-shunting. Post-shunt, 56% of patients received additional systemic therapy or started or completed WBRT. Complications included infection (5%), symptomatic subdural hygroma/hematoma (6.3%), and shunt externalization/removal/repair (8%). Abdominal seeding was not identified.
conclusionsCSF diversion for LM with hydrocephalus and intracranial hypertension secondary to metastasis can achieve symptomatic relief, hospital discharge, and return to further oncologic therapy, with a complication profile unique to this pathophysiology. However, decision-making in this population must incorporate end-of-life goals of care given limited prognosis.
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