Evidence map›Paper›PMID 40464488›Full record

ArticleInternational journal of cancer2025

Managing hydrocephalus in patients with leptomeningeal disease: A multicenter retrospective analysis.

Obada T Alhalabi, Lukas Klein, David Wasilewski, Amine Mellal, Carmen Büsken, Clara Buszello, Giulia Cossu, Ilker Y Eyüpoglu, Andreas W Unterberg, Peter Vajkoczy and 10 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Article
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

20 authors.

Obada T AlhalabiDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.ORCID 0000-0002-5589-4297
Lukas KleinDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
David WasilewskiDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Amine MellalDepartment of Neurosurgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Carmen BüskenDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Clara BuszelloDepartment of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Giulia CossuDepartment of Neurosurgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Ilker Y EyüpogluDepartment of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Andreas W UnterbergDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Gabriele SchackertDepartment of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Mahmoud MessererDepartment of Neurosurgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Martin MischDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Tobias KesslerClinical Cooperation Unit Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Wolfgang WickClinical Cooperation Unit Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Christine JungkDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Ahmed El DamatyDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Sandro M KriegDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Tareq A JuratliDepartment of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Alexander YounsiDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Leptomeningeal disease (LMD) represents a terminal condition of tumor cell seeding that can cause symptomatic hydrocephalus. With improved survival rates under systemic therapy, the role of cerebrospinal fluid (CSF) drainage through ventriculo-peritoneal shunt (VPS) or Rickham reservoir (RR) placement in LMD patients is gaining more relevance. This study aimed to compare outcomes of both modalities in a multicentric contemporary cohort. A retrospective analysis of medical charts in patients receiving VPS for LMD and malresorptive hydrocephalus in two neurosurgical centers between 2006 and 2021 yielded 64 patients. The most common underlying oncological conditions were breast (n = 32, 49%) and non-small cell lung cancer (NSCLC, n = 16, 25%). The median time between primary and LMD diagnosis was 23.3 months (11.2 to 43.4 months). Symptoms of intracranial hypertension were relieved in 79% of cases (n = 50) after shunting, with 42 (66%) and 32 patients (50%) receiving systemic and intrathecal therapy, respectively. A further multicenter analysis comparing patients receiving VPS with patients receiving RR (with regular tapping) included 155 patients (VPS: n = 80, 52%; RR: n = 75, 48%). Compared to VPS, RRs were associated with a lower surgical revision rate (8% vs. 24%, p = 0.009). There was no difference in median overall survival in VPS patients (118 days) compared to RR patients (80 days, p = 0.180). Given this data showing a short and comparable survival of patients under both modalities with a lower RR complication rate, a rationale for an initial Rickham implantation in LMD patients with hydrocephalus, with later VPS conversion for long-term surviving patients, could be contemplated.

Indexed as

HydrocephalusMeningeal CarcinomatosisMeningeal NeoplasmsVentriculoperitoneal ShuntAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeCSF diversionintrathecal therapyleptomeningeal diseaseRickham reservoirventriculoperitoneal shunt

Identifiers

PMID40464488
PMCPMC12375857

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.