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Clinical outcome of cerebrospinal fluid shunts in patients with leptomeningeal carcinomatosis

DC Field Value Language
dc.contributor.authorKim, Hye Seon-
dc.contributor.authorPark, Jong Bae-
dc.contributor.authorGwak, Ho-Shin-
dc.contributor.authorKwon, Ji-Woong-
dc.contributor.authorShin, Sang-Hoon-
dc.contributor.authorYoo, Heon-
dc.date.accessioned2019-05-09T01:18:15Z-
dc.date.available2019-05-09T10:19:31Z-
dc.date.issued2019-03-27-
dc.identifier.citationWorld Journal of Surgical Oncology, 17(1):59ko_KR
dc.identifier.issn1477-7819-
dc.identifier.urihttps://hdl.handle.net/10371/153120-
dc.description.abstractBackground
Leptomeningeal carcinomatosis (LMC) is frequently associated with hydrocephalus, which quickly devastates the performance of the patient. Cerebrospinal fluid (CSF) shunt is a widely accepted treatment of choice, but the clinical outcomes in patients with LMC are not well studied. This study aimed to examine the efficacy of a CSF shunt in patients with LMC.

Methods
Seventy patients with LMC confirmed by cytology or magnetic resonance imaging (MRI) underwent ventriculoperitoneal (VP) or lumboperitoneal (LP) shunt surgery. We retrospectively analyzed the clinical characteristics of patients, symptom improvement after the shunt, rate of complications associated with the surgery, and overall survival.

Results
Fifty-five patients had systemic cancer as a preceding disease, including lung cancer (45), breast cancer (6), and others (4). Primary brain tumors were mainly glioma (7) and medulloblastoma (5). Fifty-one patients had VP shunt, and 19 had LP shunt. After surgery, preoperative symptoms improved in 35 patients (50%) and were normalized in 24 of those patients (34%). Shunt malfunction occurred in eight patients, and infection occurred in eight patients. Seventeen patients underwent revision due to infection, shunt malfunction, or over-drainage. There were no complications associated with peritoneal seeding during a median follow-up of 3.3 months after surgery. The median overall survival was 8.7 months (95% confidence interval, 6.0–11.4) from LMC diagnosis and 4.1 months from shunt surgery.

Conclusion
VP or LP shunt is effective for patients with hydrocephalus from LMC in terms of symptom improvement and prolonging of overall survival with an acceptable rate of procedure-related complications.


Trial registration
This study was approved by the Institutional Review Board (IRB) of the National Cancer Center (retrospectively registered,
NCC2018-0051

).
ko_KR
dc.description.sponsorshipThis work was supported by grants from National Cancer Center, Korea (1710871-2, 1810121-2), and a grant of the Korea Health Industry Development Institute, funded by the Ministry of Health & welfare,
Republic of Korea (grant no: HI17C1018)
ko_KR
dc.language.isoenko_KR
dc.publisherBioMed Centralko_KR
dc.subjectCerebrospinal fluidko_KR
dc.subjectComplicationko_KR
dc.subjectEfficacyko_KR
dc.subjectLeptomeningeal carcinomatosisko_KR
dc.subjectShuntko_KR
dc.titleClinical outcome of cerebrospinal fluid shunts in patients with leptomeningeal carcinomatosisko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor김혜선-
dc.contributor.AlternativeAuthor박종배-
dc.contributor.AlternativeAuthor곽호신-
dc.contributor.AlternativeAuthor권지웅-
dc.contributor.AlternativeAuthor신상훈-
dc.contributor.AlternativeAuthor유헌-
dc.identifier.doi10.1186/s12957-019-1595-7-
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2019-03-31T03:15:45Z-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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