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10-10-2023 | Metastasis | Review

Pachymeningeal disease: a systematic review and metanalysis

Authors: Enrique Gutiérrez-Valencia, Irving Sánchez, Adrián Valles, Omar Díaz, Tomás F. González, Ricardo Balderrama, Jesús Fuentes, Victor Ruiz, José Rodríguez, Carlos Saavedra, Lorena Velázquez-Pulido, Eduard Cadavid, Luis E. Ayala-Hernández, Alejandro Villalvazo, Luis H. Bayardo, Kurl Jamora, Aristotelis Kalyvas, Kaiyun Yang, Barbara-Ann Millar, David B. Shultz

Published in: Journal of Neuro-Oncology | Issue 1/2023

Abstract

Background

Pachymeningeal disease (PMD) is a newly recognized pattern of brain metastasis (BrM) failure that specifically occurs following surgery with adjuvant stereotactic radiosurgery (SRS) and has unique prognostic implications relative to leptomeningeal disease (LMD). Here, we report its prevalence, prognostic implications, and associated risk factors.

Methods

A literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses on PUBMED and Cochrane from January 2000 to June 2023.

Results

We identified 12 studies that included a total of 3992 BrM patients, 659 (16.5%) of whom developed meningeal disease (MD) following surgery plus adjuvant SRS, including either PMD or LMD. The mean prevalence of MD across studies was 20.9% (7.9–38.0%), with PMD accounting for 54.6% of this prevalence and LMD comprising the remaining 45.4%. Mean of the median overall survivals following diagnosis of PMD and LMD was 10.6 months and 3.7 months p = 0.007, respectively, a significant difference. Only 2 risk factors for PMD were reported in ≥ 2 studies and also identified as statistically significant per our meta-analysis: infratentorial location and controlled systemic disease status.

Conclusion

While PMD has a superior prognosis to LMD, it is nevertheless a critical oncologic event associated with significant mortality and remains poorly recognized. PMD is predominantly observed in patients with controlled systemic disease status and infratentorial location. Future treatment strategies should focus on reducing surgical seeding and sterilizing surgical cavities.

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Title: Pachymeningeal disease: a systematic review and metanalysis
Authors: Enrique Gutiérrez-Valencia
Irving Sánchez
Adrián Valles
Omar Díaz
Tomás F. González
Ricardo Balderrama
Jesús Fuentes
Victor Ruiz
José Rodríguez
Carlos Saavedra
Lorena Velázquez-Pulido
Eduard Cadavid
Luis E. Ayala-Hernández
Alejandro Villalvazo
Luis H. Bayardo
Kurl Jamora
Aristotelis Kalyvas
Kaiyun Yang
Barbara-Ann Millar
David B. Shultz
Publication date: 10-10-2023
Publisher: Springer US
Keyword: Metastasis
Published in: Journal of Neuro-Oncology / Issue 1/2023
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04476-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pachymeningeal disease: a systematic review and metanalysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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