title: Surgical Ventricular Entry is a Key Risk Factor for Leptomeningeal Metastasis of High Grade Gliomas.
abstract: Leptomeningeal metastasis (LM) of high grade gliomas (HGG) can lead to devastating disease courses. Understanding of risk factors for LM is important to identify patients at risk. We reviewed patient records and magnetic resonance imaging (MRI) of all patients with a first diagnosis of HGG who underwent surgery in our institution between 2008 and 2012. To assess the influence of potential risk factors for LM and the impact of LM on survival multivariate statistics were performed. 239 patients with a diagnosis of HGG and at least 6 months of MRI and clinical follow-up were included. LM occurred in 27 (11%) patients and was symptomatic in 17 (65%). A strong correlation of surgical entry to the ventricle and LM was found (HR: 8.1). Ventricular entry was documented in 137 patients (57%) and LM ensued in 25 (18%) of these. Only two (2%) of 102 patients without ventricular entry developed LM. Median overall survival of patients after diagnosis of LM (239 days) was significantly shorter compared to patients without LM (626 days). LM is a frequent complication in the course of disease of HGG and is associated with poor survival. Surgical entry to the ventricle is a key risk factor for LM.
authors.affiliation: Department of Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.|Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg.
authors.forename: Roland
authors.initials: R
authors.lastname: Roelz
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg.
authors.forename: Peter
authors.initials: P
authors.lastname: Reinacher
authors.affiliation: Department of Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.|Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, 45147, Germany.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Jabbarli
authors.affiliation: Department of Nursing-IT, University Medical Center Freiburg, Hugstetter Str. 55, 79106 Freiburg.
authors.forename: Rainer
authors.initials: R
authors.lastname: Kraeutle
authors.affiliation: Department of Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Hippchen
authors.affiliation: Department of Neuroradiology, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Egger
authors.affiliation: Department of Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Weyerbrock
authors.affiliation: Department of Neurosurgery, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany.
authors.forename: Marcia
authors.initials: M
authors.lastname: Machein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002552:Cerebral Ventricles / Q000601:surgery*; D014695:Cerebral Ventriculography; D005260:Female; D005910:Glioma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*