2016 Volume 55 Issue 5 Pages 308-314
Objective : Leptomeningeal carcinomatosis (LC), which is associated with a poor prognosis, is a condition in which malignant cells diffusely spread to the leptomeninges. We review herein epidemiological data on LC patients with adenocarcinoma diagnosed with cytological examination and treated at Niigata Cancer Center Hospital.
Study Design : We analyzed 5812 cerebrospinal fluid cytology specimens from 1310 LC cases between 1992 and 2013.
Results : During 22 years, the number of LC patients increased by more than five times. In adenocarcinoma cases, an increasing tendency was clearly seen from 2006. CSF cytology positive for malignancy was identified in 1267 specimens from 407 cases. There were 245 cases of epithelial tumors including 220 cases of adenocarcinoma. Primary sites of adenocarcinoma cases were the lungs (115), breasts (76), stomachs (14), etc. The average of the LC-free survival in breast cancer patients was 79.2 months, which was statistically longer than in lung and gastric cancers (p<0.01). In lung cancer, the overall survival after diagnosis of LC between 2006 and 2013 was 6.6 months, which was about three times longer than in cases before 2005 (p<0.01).
Conclusions : Increments in central nerve system metastasis were seen according to the progress of anticancer therapy. The cytological diagnosis of LC will obviously increase the opportunity for early diagnosis and appropriate treatment.
