Photo Credit: Tonpor Kasa

The following is a summary of “Prognostic Role of Ventricular Size and Its Dynamics in Patients With Leptomeningeal Metastasis From Solid Tumors,” published in the February 2024 issue of Neurology by Rhun et al.

Researchers conducted a retrospective study to investigate whether the size of ventricles, as measured by the Evans index (EI), could predict patient outcomes in cases of leptomeningeal metastasis (LM) from solid tumors.

They reviewed charts from three academic hospitals to find patients with LM from solid tumors, which helped prognostic links investigation with the EI at diagnosis, initial follow-up, and disease progression.

The results showed 113 patients with a median age of 58.3 years (IQR] 46.1–65.8), with 41 patients (36%) male and 72 patients (64%) female. The most common cancers were lung (n = 39), breast (n = 36), and melanoma (n = 23). The median EI at baseline was 0.28 (IQR 0.26–0.31); 67 patients (59%) had EI ≥ 0.27, and 37 patients (33%) had EI ≥ 0.30. Among those with MRI follow-up, 52% showed an EI increase ≥ 0.01, including 30% without and 59% with LM progression. At LM progression, 53% had an EI increase ≥ 0.01. Median survival was 2.9 months (IQR 1–7.2). Patients with baseline EI < 0.27 survived longer than those with EI ≥ 0.27 (5.3 months, IQR 2.4–10.8, vs 1.3 months, IQR 0.6–4.1) (HR 1.70, 95% CI 1.135–2.534, P=0.0099). Median survival was 3.7 months (IQR 1.4–8.3) with EI < 0.30 vs 1.8 months (IQR 0.8–4.1) with EI ≥ 0.30 (HR 1.40, 95% CI 0.935–1.243, P=0.1113). Among those with follow-up scans, overall survival was 9.4 months (IQR 5.6–21.0) for stable/decreased EI vs 5.6 months (IQR 2.5–10.5) for increased EI (HR 1.08, 95% CI 0.937–1.243; P=0.300).

They concluded that higher EI at baseline predicted worse LM progression, and increasing EI during follow-up suggested poorer outcomes.

Source: neurology.org/doi/10.1212/WNL.0000000000207959