Intracranial dural metastases Journal Article
| Authors: | Nayak, L.; Abrey, L. E.; Iwamoto, F. M. |
| Article Title: | Intracranial dural metastases |
| Abstract: | Background: Intracranial dural metastases (IDM) are found at autopsy in 9% of patients with advanced systemic cancer. However, to the authors' knowledge, IDM have not been studied systematically in the modern neuroimaging era. The objective of the current study was to evaluate the demographics, clinical presentation, imaging, treatment, and prognosis of patients with IDM. METHODS: The current study was a retrospective review of 122 patients with IDM diagnosed at Memorial SIoan-Kettering Cancer Center between 1999 and 2006. Patients with concurrent brain or leptomeningeal metastases were excluded. RESULTS: Sixty-one percent of the patients were women; the median age at diagnosis was 59 years, the median Karnofsky performance scale (KPS) at diagnosis was 80, and the median time to IDM diagnosis from initial cancer diagnosis was 37 months. Breast (34%) and prostate (17%) cancers were the most frequent primary tumors associated with IDM. Fifty-six percent of patients had a single dural metastasis. On imaging, 70% had metastases of the overlying skull, 44% had dural tail metastases, 53% had vasogenic edema, and 34% had brain invasion. Direct extension from skull metastases was the most common mode of spread. Eighty-three percent of patients had active systemic disease at the time of IDM diagnosis. A lower KPS and lung cancer were associated with worse overall survival. Surgical resection and chemotherapy improved progression-free survival, but only resection was found to be associated with improved overall survival. CONCLUSIONS: IDM affect a significant proportion of cancer patients. KPS and status of systemic cancer should guide treatment decisions. © 2009 American Cancer Society. |
| Keywords: | cancer chemotherapy; child; human tissue; treatment outcome; disease-free survival; cancer surgery; retrospective studies; major clinical study; overall survival; clinical feature; bone metastasis; cancer patient; magnetic resonance imaging; antineoplastic agent; cancer diagnosis; demography; progression free survival; breast cancer; lung cancer; tomography, x-ray computed; diagnostic imaging; retrospective study; cancer therapy; central nervous system; prostate cancer; cancer center; karnofsky performance status; meningeal neoplasms; brain metastasis; clinical decision making; meningioma; dura mater; brain edema; intracranial neoplasms; neoplasm metastases; intracranial dural metastasis |
| Journal Title: | Cancer |
| Volume: | 115 |
| Issue: | 9 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2009-05-01 |
| Start Page: | 1947 |
| End Page: | 1953 |
| Language: | English |
| DOI: | 10.1002/cncr.24203 |
| PUBMED: | 19241421 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: CANCA" - "Source: Scopus" |
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