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Purpose <p>To identify risk factors for development of leptomeningeal disease (LMD) in patients with resected brain metastases (BM) based on the multicentric <i>SUBARoMA</i> study-cohort.</p> Methods <p>The <i>SUBARoMA</i> study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.</p> Results <p>We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (<i>p</i> = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (<i>p</i> = 0.002), while postoperative systemic therapy (<i>p</i> &lt; 0.001) represented a protective factor. Incomplete resection (<i>p</i> = 0.003; HR 1.810; 95%CI 1.218–2.690) and postoperative systemic therapy (<i>p</i> = 0.028; HR 0.641; 95%CI 0.431–0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.</p> Conclusion <p>Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.</p>

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Leptomeningeal disease (LMD) after resection of brain metastases: results of the multicenter SUBAROMA study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Laura Mühlhausen,
  • Martin Kocher,
  • Hanah Hadice Karadachi,
  • Ulrich Sure,
  • Yahya Ahmadipour,
  • Levin Häni,
  • Danial Nasiri,
  • Tommaso Araceli,
  • Martin Proescholdt,
  • Nils Ole Schmidt,
  • Andrea Cattaneo,
  • Vera Nickl,
  • Florian Scheichel,
  • Franz Marhold,
  • Stefan J. Grau,
  • Christina A. Hamisch,
  • Franz L. Ricklefs,
  • Yahya Zghaibeh,
  • Roland H. Goldbrunner,
  • Stephanie T. Jünger

摘要

Purpose

To identify risk factors for development of leptomeningeal disease (LMD) in patients with resected brain metastases (BM) based on the multicentric SUBARoMA study-cohort.

Methods

The SUBARoMA study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.

Results

We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (p = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (p = 0.002), while postoperative systemic therapy (p < 0.001) represented a protective factor. Incomplete resection (p = 0.003; HR 1.810; 95%CI 1.218–2.690) and postoperative systemic therapy (p = 0.028; HR 0.641; 95%CI 0.431–0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.

Conclusion

Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.