Evidence map›Paper›PMID 39932528›Full record

ArticleJournal of neuro-oncology2025

Clinical characteristics and outcomes in leptomeningeal disease with or without brain metastasis: insights from an explorative data analysis of the Charité LMD registry.

David Wasilewski, Chiara Eitner, Rober Ates, Selin Murad, Zoe Shaked, Julia Alexandra Steinle, Andreas Wetzel-Yalelis, Tarik Alp Sargut, Judith Rösler, Majd Abdulhamid Samman and 19 more

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Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

David WasilewskiDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany. David.Wasilewski@med.uni-duesseldorf.de.
Chiara EitnerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Rober AtesDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Selin MuradDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Zoe ShakedDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Julia Alexandra SteinleDepartment of Gynecology, Charité, Universitätsmedizin Berlin, Germany, Corporate Member of Freie, Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Andreas Wetzel-YalelisDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Tarik Alp SargutDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Judith RöslerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Majd Abdulhamid SammanDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Peter TruckenmüllerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Robert MertensDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Daniel KronebergBerlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin Institute of Health (BIH) Charité, Charitéplatz 1, 10117, Berlin, Germany.
Alexander KowskiDepartment of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Helena RadbruchDepartment of Neuropathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
David CapperGerman Cancer Consortium (DKTK), Partner Site Berlin, a partnership between DKFZ and Charité - Universitätsmedizin Berlin, Berlin, Germany.
Felix EhretGerman Cancer Consortium (DKTK), Partner Site Berlin, a partnership between DKFZ and Charité - Universitätsmedizin Berlin, Berlin, Germany.
Siyer RoohaniGerman Cancer Consortium (DKTK), Partner Site Berlin, a partnership between DKFZ and Charité - Universitätsmedizin Berlin, Berlin, Germany.
Nikolaj FrostDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Jawed NawabiBerlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin Institute of Health (BIH) Charité, Charitéplatz 1, 10117, Berlin, Germany.
Julia OnkenDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.
Maximilian SchlaakDepartment of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Jens-Uwe BlohmerCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Charité Comprehensive Cancer Center, Berlin, Germany.
Uwe PelzerCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Charité Comprehensive Cancer Center, Berlin, Germany.
Ulrich KellerCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Charité Comprehensive Cancer Center, Berlin, Germany.
Jalid SehouliCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Charité Comprehensive Cancer Center, Berlin, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany. peter.vajkoczy@charite.de.
Ulrich Keilholz *Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Charité Comprehensive Cancer Center, Berlin, Germany.
Martin Misch *Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Hum-Boldt-Universität Zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION AND

objectivesLeptomeningeal disease (LMD) involves disseminating cancer cells to the leptomeninges and cerebrospinal fluid. The impact of intracranial parenchymal brain metastases and extracranial disease burden at LMD diagnosis remains unclear. This study evaluates these factors alongside local and systemic therapies before and after LMD diagnosis.

methodsA retrospective analysis was conducted on 188 patients diagnosed with LMD between 2011 and 2024. Data on demographics, imaging findings, and treatments were collected. Kaplan-Meier estimates were used for survival analysis, and independent prognostic factors were identified using a backward-stepwise Cox regression model.

resultsPrimary cancers included breast cancer (34.0%), non-small cell lung cancer (22.3%), and melanoma (14.4%). LMD was diagnosed via MRI in 56.4% of cases, cerebrospinal fluid (CSF) cytology in 2.7%, and both in 41.0%. Median overall survival was 2.8 months [95% CI: 2.4 - 3.7]. Independent prognostic factors for improved survival included male sex (HR: 0.61 [95% CI: 0.40 - 0.93], p = 0.020), absence of hydrocephalus at LMD diagnosis (HR: 0.42 [95% CI: 0.22 - 0.79], p = 0.007), and targeted therapy post-diagnosis (HR: 0.33 [95% CI: 0.20 - 0.55], p < 0.001). Two or more lines of systemic therapy before LMD diagnosis increased mortality risk (HR: 1.73 [95% CI: 1.16 - 2.59], p = 0.007). Lack of CNS parenchymal disease at LMD diagnosis also increased risk (HR: 0.51 [95% CI: 0.30 - 0.89], p = 0.017). Pre-diagnosis radiation therapy showed no survival benefit, while post-diagnosis radiation improved outcomes (HR: 0.47 [95% CI: 0.32 - 0.70], p < 0.001).

conclusionAbsence of hydrocephalus and use of targeted therapy post-diagnosis are favorable prognostic factors, while extensive prior systemic therapy and CNS parenchymal disease worsen outcomes. Tailored therapies addressing intracranial disease are crucial for improving survival in LMD patients.

Indexed as

Brain NeoplasmsMeningeal CarcinomatosisMeningeal NeoplasmsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRegistriesRetrospective StudiesSurvival RateBrain metastasisBreast cancerLung cancerMelanomaRadiotherapyRe-resectionResectionSurvival

Identifiers

PMID39932528
PMCPMC12511199

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