Prognostic factors and clinical features in patients with leptominengeal metastases from breast cancer: a single center experience

Abstract

Background: Meningeal carcinomatosis (MC) is a rare complication in breast cancer (BC) with no efficient modality of treatment yet found; overall survival (OS) generally did not exceed six months. We reviewed the experience of the University of Florence focusing on prognostic factors and MC survival.

Patients and methods: We analyzed 33 patients treated for MC from BC between 2002 and 2010.

Results: Mean OS from MC diagnosis was 4·9 months. At survival analysis clinical stage emerged as the only statistical significant parameter (P = 0·009) among BC diagnosis features. Among MC diagnosis parameters, more than three metastases at diagnosis (P = 0·037), multimodality treatment (P = 0·014) and poor performance status (P = 0·003) reached the statistical significance. At multivariate analysis only performance status at MC diagnosis maintained the statistical significance (P = 0·0047; HR: 3·34; CI 95% 1·45–7·73).

Conclusions: Our experience confirms that performance status is probably the most important prognostic factor in these patients. Multimodality approach is probably the best option.

Keywords:

• Breast cancer
• Prognostic factors
• Leptomeningeal metastases
• Meningeal carcinomatosis
• Performance status