Thursday, January 29, 2009

Prognosis of leptomeningeal carcinomatosis

Cancer has a paper looking at the prognosis of leptomeningeal carcinomatosis. It's a single-institution (Spain) case series looking at 70 patients diagnosed with leptomeningeal carcinomatosis (LC), and gives some prognostic data. Mean age was 55 years, ~40% each had breast cancer and lung cancer (the remainder being a smattering of other solid tumors), and about half received specific treatment directed at the LC. The median overall survival was 21 days (although with a range up to 2000+ days). Of those who received intrathecal chemotherapy, median survival was 108 days. Good performance status, higher CSF glucose, and the presense of 'infratentorial' (cranial nerve and spinal symptoms) as opposed to 'supratentorial' symptoms (e.g. seizures, encephalopathy) were associated with improved survival. Apparently cancer type was not associated with survival in this series. Patients who received no chemotherapy were older, with worse performance statuses, etc. and it's impossible to say how much of the survival difference is due to underlying factors vs. treatment effects.