Risk of neoplastic meningitis following surgical resection of cerebellar metastases.
BACKGROUND
Based on limited literature, an at risk group of patients for development of neoplastic meningitis (NM) are those with resected cerebellar parenchymal metastases.


OBJECTIVE
Characterize the incidence of NM in patients with cerebellar metastases treated with either surgical resection or radiotherapy.


METHODS
A retrospective study to determine outcome and in particular the occurrence of NM in 30 patients with resected cerebellar metastases (Group 1) and in 50 patients with cerebellar metastases treated with radiotherapy only (Group 2). Additionally, 10 patients with coincident cerebellar metastases and NM were identified (Group 3) and compared with these groups.


RESULTS
Median survival in Group 1 was 8 months (range 4-24 months). A single patient (1/30; 3%) in this cohort developed NM that was not treated. Median survival in Group 2 was 4 months (range 1.5-18 months). Two patients (2%) in Group 2 developed NM, in neither was the NM treated. Group 3 had a median survival of 3 months (range 1-6 months). No patient in Group 3 had a history of prior posterior fossa surgery.


CONCLUSIONS
The incidence of NM following resection of cerebellar metastases (3%: Group 1) was no greater than that seen following treatment of cerebellar metastases with radiotherapy only (2%; Group 2). In addition, in a large data base of patients with NM (40% with parenchymal metastases), cerebellar metastases occurred at a proportion (10%; Group 3) expected based on proportional brain volume and cerebral blood flow.
Chamberlain
Marc C
MC
Department of Neurology and Neurosurgical Surgery, University of Washington, Fred Hutchinson Cancer Center, Seattle Cancer Care Alliance, 825 Eastlake Avenue E, Seattle, WA 98109-1023, USA. chambemc@u.washington.edu
D000328:Adult; D000368:Aged; D002528:Cerebellar Neoplasms / Q000453:epidemiology* / Q000556:secondary / Q000601:surgery; D002531:Cerebellum / Q000473:pathology* / Q000601:surgery*; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D008578:Meninges / Q000473:pathology; D008582:Meningitis, Aseptic / Q000453:epidemiology*; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology / Q000503:physiopathology; D019635:Neurosurgical Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate