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Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors

OBJECTIVE: Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. METHODS: We retrospectively reviewed data from 376 World Health Organization (WHO) grade...

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Autores principales: Yang, Jeyul, Kwon, Ji-Woong, Shin, Sang Hoon, Yoo, Heon, Wang, Kyu-Chang, Lee, Sang Heyon, Gwak, Ho-Shin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurosurgical Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323273/
https://www.ncbi.nlm.nih.gov/pubmed/36503217
http://dx.doi.org/10.3340/jkns.2022.0166
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author Yang, Jeyul
Kwon, Ji-Woong
Shin, Sang Hoon
Yoo, Heon
Wang, Kyu-Chang
Lee, Sang Heyon
Gwak, Ho-Shin
author_facet Yang, Jeyul
Kwon, Ji-Woong
Shin, Sang Hoon
Yoo, Heon
Wang, Kyu-Chang
Lee, Sang Heyon
Gwak, Ho-Shin
author_sort Yang, Jeyul
collection PubMed
description OBJECTIVE: Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. METHODS: We retrospectively reviewed data from 376 World Health Organization (WHO) grade II–IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. RESULTS: A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0–60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384–4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379–6.561; p=0.006). CONCLUSION: Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly.
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spelling pubmed-103232732023-07-07 Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors Yang, Jeyul Kwon, Ji-Woong Shin, Sang Hoon Yoo, Heon Wang, Kyu-Chang Lee, Sang Heyon Gwak, Ho-Shin J Korean Neurosurg Soc Clinical Article OBJECTIVE: Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. METHODS: We retrospectively reviewed data from 376 World Health Organization (WHO) grade II–IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. RESULTS: A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0–60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384–4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379–6.561; p=0.006). CONCLUSION: Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly. Korean Neurosurgical Society 2023-07 2022-12-12 /pmc/articles/PMC10323273/ /pubmed/36503217 http://dx.doi.org/10.3340/jkns.2022.0166 Text en Copyright © 2023 The Korean Neurosurgical Society https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Yang, Jeyul
Kwon, Ji-Woong
Shin, Sang Hoon
Yoo, Heon
Wang, Kyu-Chang
Lee, Sang Heyon
Gwak, Ho-Shin
Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title_full Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title_fullStr Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title_full_unstemmed Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title_short Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors
title_sort leptomeningeal metastasis in gliomas : clinical characteristics and risk factors
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323273/
https://www.ncbi.nlm.nih.gov/pubmed/36503217
http://dx.doi.org/10.3340/jkns.2022.0166
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