Journal of neuro-oncology · 2026
Leptomeningeal disease (LMD) after resection of brain metastases: results of the multicenter SUBAROMA study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Mühlhausen Laura, Kocher Martin, Karadachi Hanah Hadice, Sure Ulrich, Ahmadipour Yahya, Häni Levin, Nasiri Danial, Araceli Tommaso, Proescholdt Martin, Schmidt Nils Ole, Cattaneo Andrea, Nickl Vera, Scheichel Florian, Marhold Franz, Grau Stefan J, Hamisch Christina A, Ricklefs Franz L, Zghaibeh Yahya, Goldbrunner Roland H, Jünger Stephanie T
Аннотация
PURPOSE: To identify risk factors for development of leptomeningeal disease (LMD) in patients with resected brain metastases (BM) based on the multicentric SUBARoMA study-cohort.
METHODS: The SUBARoMA study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.
RESULTS: We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (p = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (p = 0.002), while postoperative systemic therapy (p < 0.001) represented a protective factor. Incomplete resection (p = 0.003; HR 1.810; 95%CI 1.218-2.690) and postoperative systemic therapy (p = 0.028; HR 0.641; 95%CI 0.431-0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.
CONCLUSION: Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.
METHODS: The SUBARoMA study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.
RESULTS: We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (p = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (p = 0.002), while postoperative systemic therapy (p < 0.001) represented a protective factor. Incomplete resection (p = 0.003; HR 1.810; 95%CI 1.218-2.690) and postoperative systemic therapy (p = 0.028; HR 0.641; 95%CI 0.431-0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.
CONCLUSION: Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.