Yuta Murakami1, Masahiro Ichikawa2, Mudathir Bakhit3, Shinya Jinguji4, Taku Sato5, Masazumi Fujii6, Jun Sakuma7, Kiyoshi Saito8. 1. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: y-mura@fmu.ac.jp. 2. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: masamasa@fmu.ac.jp. 3. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: m-bakhit@fmu.ac.jp. 4. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: Jinguji@fmu.ac.jp. 5. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: tak-s@fmu.ac.jp. 6. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: fujiim@fmu.ac.jp. 7. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: jsakuma@fmu.ac.jp. 8. Department of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan. Electronic address: kiyoshis@fmu.ac.jp.
Abstract
OBJECTIVES: Leptomeningeal metastasis (LM) is associated with poor prognosis and affects the quality of life (QOL) of end-stage cancer patients. Severe headache associated with hydrocephalus causes reduced QOL. We investigated the clinical value of surgical treatment for hydrocephalus in LM patients. PATIENTS AND METHODS: The medical records of 11 consecutive patients who underwent lumboperitoneal shunt (LPS) or ventriculoperitoneal shunt (VPS) at our institution between 2007 and 2016 were investigated. Primary brain tumor patients were excluded. We assessed the neurological status and therapeutic effects at 1 month after the shunt surgery. RESULTS: The patients were three males and eight females with a median age of 58 years (interquartile range [IR] 52-68 years). The median preoperative neutrophil-to-lymphocyte ratio was 6.4 (IR 4.8-9.2). Symptom improvement was observed in nine patients, and severe headache was relieved in seven (88%) out of eight patients. The median Karnofsky performance status scale increased from 40 to 60, and the median overall survival after primary malignancy diagnosis was 27.4 months (IR 19.6-63.1 months). The median survival after the diagnosis of brain parenchymal metastasis, LM, and shunt surgery were 7.2 months (IR 5.1-14.1 months), 3.9 months (IR 3.5-6.3 months), and 3.3 months (IR 2.9-5.7 months), respectively. CONCLUSION: Shunt surgery for hydrocephalus could offer an effective palliative surgical option for symptom relief especially relief of severe headache, contributing improvement of QOL in LM patients.
OBJECTIVES: Leptomeningeal metastasis (LM) is associated with poor prognosis and affects the quality of life (QOL) of end-stage cancerpatients. Severe headache associated with hydrocephalus causes reduced QOL. We investigated the clinical value of surgical treatment for hydrocephalus in LM patients. PATIENTS AND METHODS: The medical records of 11 consecutive patients who underwent lumboperitoneal shunt (LPS) or ventriculoperitoneal shunt (VPS) at our institution between 2007 and 2016 were investigated. Primary brain tumorpatients were excluded. We assessed the neurological status and therapeutic effects at 1 month after the shunt surgery. RESULTS: The patients were three males and eight females with a median age of 58 years (interquartile range [IR] 52-68 years). The median preoperative neutrophil-to-lymphocyte ratio was 6.4 (IR 4.8-9.2). Symptom improvement was observed in nine patients, and severe headache was relieved in seven (88%) out of eight patients. The median Karnofsky performance status scale increased from 40 to 60, and the median overall survival after primary malignancy diagnosis was 27.4 months (IR 19.6-63.1 months). The median survival after the diagnosis of brain parenchymal metastasis, LM, and shunt surgery were 7.2 months (IR 5.1-14.1 months), 3.9 months (IR 3.5-6.3 months), and 3.3 months (IR 2.9-5.7 months), respectively. CONCLUSION: Shunt surgery for hydrocephalus could offer an effective palliative surgical option for symptom relief especially relief of severe headache, contributing improvement of QOL in LM patients.
Authors: Evan D Bander; Melissa Yuan; Anne S Reiner; Andrew L A Garton; Katherine S Panageas; Cameron W Brennan; Viviane Tabar; Nelson S Moss Journal: J Neurooncol Date: 2021-08-18 Impact factor: 4.506
Authors: Rimas V Lukas; Jigisha P Thakkar; Massimo Cristofanilli; Sunandana Chandra; Jeffrey A Sosman; Jyoti D Patel; Priya Kumthekar; Roger Stupp; Maciej S Lesniak Journal: J Neurooncol Date: 2022-01-20 Impact factor: 4.130