Leptomeningeal Metastases of the Spine: A Systematic Review

Paolo Palmisciano, Navraj S. Sagoo, Abdurrahman F. Kharbat, Yves J. Kenfack, Othman B.I.N. Alamer, Gianluca Scalia, Giuseppe E. Umana, Salah G. Aoun, Ali S. Haider

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Background/Aim: Leptomeningeal metastases (LMs) of the spine have complex management. We reviewed the literature on spine LMs. Materials and Methods: PubMed, EMBASE, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA guidelines to include studies of spine LMs. Results: We included 46 studies comprising 72 patients. The most frequent primary tumors were lung (19.4%) and breast cancers (19.4%). Median time from primary tumors was 12 months (range=0-252 months). Cauda equina syndrome occurred in 34 patients (48.6%). Nodular spine LMs (63.6%) were more frequent. Concurrent intracranial LMs were present in 27 cases (50.9%). Cerebrospinal fluid cytology was positive in 31 cases (63.6%). Cases were managed using palliative steroids (73.6%) with locoregional radiotherapy (55.6%) chemotherapy (47.2%), or decompressive laminectomy (8.3%). Post-treatment symptom improvement (32%) and favorable radiological response (28.3%) were not different based on treatment (p=0.966; p=0.727). Median overall-survival was 3 months (range=0.3-60 months), not significantly different between radiotherapy and chemotherapy (p=0.217). Conclusion: Spine LMs have poor prognoses. Radiotherapy, chemotherapy, and surgery are only palliative, as described for intracranial LMs.

Original languageEnglish (US)
Pages (from-to)619-628
Number of pages10
JournalAnticancer Research
Volume42
Issue number2
DOIs
StatePublished - Feb 2022

Keywords

  • Leptomeningeal metastases
  • Radiotherapy
  • Spine metastases
  • Spine surgery
  • Spine tumors
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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