To identify risk factors for postoperative leptomeningeal disease (LMD) development in patients with brain metastases (BM) who underwent surgical treatment.
Approach:
Study Design: A multicenter, retrospective cohort study was conducted across eight neurosurgical departments in Germany, Austria, and Switzerland.
Patient Inclusion: Patients aged ≥ 18 years who had initial surgery for BM between 2012 and 2022 and no prior local treatment of BM were included.
Data Acquisition: Demographic, clinical, treatment, and outcome parameters were collected from electronic patient records and analyzed.
Statistical Analysis: Statistical significance was assessed using Kaplan-Meier methods and Cox regression models.
Key Findings:
LMD is associated with poor prognosis and reduced overall survival in patients with BM, as indicated by the study.
The study found that high overall disease burden, anatomical location of BM, and treatment-related factors increase the risk of developing LMD.
Postoperative radiation therapy type influences LMD risk, with the study linking stereotactic radiosurgery to a higher incidence compared to whole-brain radiation therapy.
Interpretation:
The study highlights the need for a better understanding of risk factors for LMD in patients with BM to improve therapeutic decision-making.
Limitations:
The study is retrospective and may be subject to biases inherent in such designs.
Heterogeneity in existing literature complicates the establishment of general recommendations.
Conclusion:
Identifying risk factors for LMD can aid in improving outcomes for patients with brain metastases.
by Laura Mühlhausen, Martin Kocher, Hanah Hadice Karadachi, Ulrich Sure, Yahya Ahmadipour, Levin Häni, Danial Nasiri, Tommaso Araceli, Martin Proescholdt, Nils Ole Schmidt, Andrea Cattaneo, Vera Nickl, Florian Scheichel, Franz Marhold, Stefan J. Grau, Christina A. Hamisch, Franz L. Ricklefs, Yahya Zghaibeh, Roland H. Goldbrunner, Stephanie T. Jünger
