Table 1.
Characteristics and outcomes of patients treated for leptomeningeal disease-associated hydrocephalus
| Study | Primary pathology (n) | No. of patients | Presenting symptoms (n) | Intervention (n) | Symptom improvement, overall rate | Symptom improvement by symptom (n) | Complications overall %; type (n) | Perioperative mortality | Median survival from LMD diagnosis (months [OQR]) | Median survival from surgery, [IQR] |
|---|---|---|---|---|---|---|---|---|---|---|
| Lokich et al. [14] | Lung adenocarcinoma (2), breast (1) | 3 | Gait issues (3), headache (2), nausea (1), cognitive changes (1) | VPS (3) | 3/3 (100%) | Gait issues (3), headache (2), nausea (1), cognitive changes (1) | N.R. | 0/3 (0%) | N.R. | 6 months (4-7.5 months] |
| Omuro et al. [5] | Breast (23), lung (6), melanoma (3), other (5) | 37 | Headache (24), nausea/vomiting (18), cognitive changes (19), gait issues (20), spinal symptoms (10), hemiparesis (12), papilledema (4) | VPS (37/37) | 27/37 (77%) | Most had decreased headache, nausea/vomiting, and improved level of alertnessa | 11%; shunt malfunction requiring revision (3), subdural hematoma (1), infection (0), peritoneal carcinomatosis (0) | 0/37 (0%) | 4 [3 days to > 3.6 years]b | 2 months [2 days to > 3.6 years]b |
| Lee et al. [11] | NSLC (29), SCLC (2), mixed NSLC/SCLC (1), breast (8), colorectal (3), renal cell (2), other (5) | 50c | Headache (35), cognitive changes (17), gait issues (7), urinary incontinence (5), seizures (2) | VPS (50/50) | 40/50 (80%) | Headache (30), cognitive changes (12), gait issues (5), urinary incontinence (2), seizures (2) | 8%; Valve malfunction (1), increased ICP (1), overdrain (1), uncontrolled hydrocephalus (1), infection (0), peritoneal carcinomatosis (0) | 1/50 (2%) | 3.5 [0–28]b | 3 months [2 days–54 months]b |
| Gonda et al. [10] | Lung (13), melanoma (10), breast (9), renal (3), colon (1) | 36d | Headache (6); headache and nausea (10); headache, nausea, vomiting (8); headache, lethargy (7); headache, neurological deficit (5) | VPS (36/36) | 27/36 (75%) | Headache (3); headache and nausea (8); headache, nausea, vomiting (8); headache, lethargy (7); headache, neurological deficit (1) | 19%; wound infection (4), shunt occlusion (2), hygroma (1), peritoneal carcinomatosis (0) | 0/36 (0%) | N.R. | 90 days [47–99 days] for LMD patients only |
| Jung et al. [24] | NSCLC (37), SCLC (8), breast (14), gastric (4), other (8) | 7e | N.R. | VPS (7/7) | N.R. | N.R. | N.R. | N.R. | N.R. | 5.7 months [95% CI 0.000–13.173 months] |
| Yamashiro et al. [1] | Lung adenocarcinoma (4) | 4 | N.R. | LPS (4) | 3/4 (75%) | N.R. | N.R. | 0/4 (0%) | N.R. | 7.5 months [4.5–15 months] |
| Murakami et al. [4] | Lung (4), breast (4), ovarian (1), colon (1), nasal rabdoidsarcoma (1) | 11 | Headache (10), nausea/vomiting (6), cognitive changes (6), gait issues (4) | LPS (3), VPS (8) | 10/11 (91%) | Headache (9), nausea/vomiting (5), cognitive changes (5), gait issues (1) | 9%; shunt obstruction requiring revision (1), infection (0), peritoneal seeding (0) | 1/11 (9%) | 3.9 [3.5–6.3] | 3.3 months [2.9–5.7 months] |
N.R. not reported, LPS lumboperitoneal shunt, VPS ventroperiotneal shunt
aSpecific numbers for each symptom not reported
bRange (minimum to maximum survival)
cIncludes 10/50 patients with parenchymal, non-LMD associated hydrocephalus
dIncludes 27/36 patients with parenchymal, non-LMD associated hydrocephalus; only 9 had LMD-associated hydrocephalus but outcomes not reported separately
eStudy included 71 patients, but only 18 had LMD-associated hydrocephalus, of whom only 7 underwent shunting