Display options
Share it on

Cancer Manag Res. 2019 Nov 20;11:9829-9841. doi: 10.2147/CMAR.S217672. eCollection 2019.

Neuraxis Metastases Of Primary Central Nervous System Tumors: A Review Of Clinicopathological And Radiographic Characters Of 198 Cases In A Single Center.

Cancer management and research

Hailong Liu, Junping Zhang, Yongqiang Liu, Youliang Sun, Cheng Li, Chunyu Gu, Haoran Wang, Hongwei Zhang, Chunjiang Yu, Mingshan Zhang

Affiliations

  1. Department of Neurosurgery, Sanbo Brain Hospital Capital Medical University, Beijing 100093, People's Republic of China.
  2. Department of Neurosurgery, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China.
  3. Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou 510405, People's Republic of China.
  4. School of Basic Medical Science, Capital Medical University, Beijing 100069, People's Republic of China.

PMID: 31819620 PMCID: PMC6876216 DOI: 10.2147/CMAR.S217672

Abstract

BACKGROUND: Neuraxis metastases (NM) from systemic and central nervous system (CNS) tumors have become increasingly common. However, a lack of systematic information restricts the development of the accurate diagnosis and treatment. The aim of this study is to facilitate the understanding of NM arising from CNS tumors in the largest cohort.

METHODS: Based on the clinicopathological and neuroimaging findings, we retrospectively analyze the epidemiological characters, radiographic classification, therapeutic strategies and prognostic factors.

RESULTS: A total of 198 cases are enrolled and the most common primary tumor is medulloblastoma (34.34%). The median age is 15.0 years and the majority of NM (79.29%) occur in the children and young adult groups. One hundred and forty-nine (75.25%) cases suffer from intracranial metastases, and 169 (85.35%) have intraspinal NM. The whole leptomeninges and cauda equine are the most preferential disseminated sites. Upon MRI parameters, the massive and miliary subgroup occurs most frequently in the intracranial and intraspinal NM, respectively. Treatment includes surgery (21.71%), chemotherapy alone (19.19%), radiation alone (10.10%) and combined therapy (55.56%). Operations are performed in order to identify pathology and relive masses, as well as the triple chemotherapeutic scheme consisting of ifosfamide, carboplatin and etoposide is recommended for most of NM. The median overall survival is 11.6 months. Younger age, coexistence of NM with primary tumors, shorter interval from primaries to metastases, glioma, leptomeningeal seeding and nodal subtype on MRI significantly correlate with poor prognosis.

CONCLUSION: In spite of controversial therapies and poor outcomes, the neuroimaging classification and comprehensive treatment contribute to the efficient administration of NM.

© 2019 Liu et al.

Keywords: MRI; classification; neuraxis metastases; operation; survival

Conflict of interest statement

The authors report no conflicts of interest in this work.

References

  1. Lung Cancer. 2012 Jul;77(1):134-9 - PubMed
  2. Curr Probl Cancer. 2007 Nov-Dec;31(6):367-424 - PubMed
  3. Clin Neurol Neurosurg. 2018 Sep;172:151-159 - PubMed
  4. J Natl Compr Canc Netw. 2015 Oct;13(10):1191-202 - PubMed
  5. J Clin Neurosci. 2017 Aug;42:84-90 - PubMed
  6. J Clin Oncol. 2005 May 20;23(15):3605-13 - PubMed
  7. Neuro Oncol. 2014 Sep;16(9):1176-85 - PubMed
  8. Cancer. 2018 Jan 1;124(1):21-35 - PubMed
  9. Surg Neurol. 2006 May;65(5):472-7; discussion 477 - PubMed
  10. Clin Neurol Neurosurg. 2012 Sep;114(7):833-9 - PubMed
  11. PLoS One. 2014 Jul 08;9(7):e100396 - PubMed
  12. Semin Oncol. 2009 Aug;36(4 Suppl 2):S35-45 - PubMed
  13. Neurology. 2010 May 4;74(18):1449-54 - PubMed
  14. Neuro Oncol. 2017 Apr 1;19(4):484-492 - PubMed
  15. Eur J Cancer. 2016 Mar;56:107-114 - PubMed
  16. Lancet Oncol. 2010 Sep;11(9):871-9 - PubMed
  17. J Neurol Sci. 2004 Aug 30;223(2):167-78 - PubMed
  18. Arch Neurol. 2010 Mar;67(3):305-12 - PubMed
  19. CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32 - PubMed
  20. J Clin Oncol. 1998 Apr;16(4):1561-7 - PubMed
  21. Clin Neurol Neurosurg. 2006 Sep;108(6):568-72 - PubMed
  22. Neuroimaging Clin N Am. 2016 Nov;26(4):601-620 - PubMed
  23. Cancer. 2003 Jul 15;98(2):363-8 - PubMed
  24. J Neurooncol. 2009 Jun;93(2):205-12 - PubMed
  25. Lancet Oncol. 2018 Jan;19(1):e43-e55 - PubMed
  26. Neurosurgery. 1999 Jul;45(1):152-5; discussion 155-7 - PubMed
  27. Lancet Neurol. 2006 May;5(5):443-52 - PubMed
  28. Nat Clin Pract Oncol. 2009 Jan;6(1):25-33 - PubMed
  29. J Neurooncol. 2006 Apr;77(2):207-12 - PubMed
  30. J Clin Neurosci. 2016 May;27:130-7 - PubMed
  31. N Engl J Med. 2001 Aug 23;345(8):621-2 - PubMed
  32. J Cancer Res Clin Oncol. 2010 Nov;136(11):1729-35 - PubMed

Publication Types