The objective of this study is to validate epidemiologic, demographic, and biomarker data from our database with current information on neoplastic meningitis (NM).

Neoplastic meningitis—the spread of a primary tumor to the leptomeninges and/or CSF occurs in 5-15% of cancer patients. If untreated, median survival is 1.5-2 months. According to prior case series, the most frequent primary cancers in NM patients are breast (27-50%), lung (22-36%), and melanoma (12%). Presenting symptoms include headache (32-75%), mental changes (33-63%), and gait abnormalities (27-36%). Studies suggest that age < 55 years and Karnofsky Performance Status (KPS) ≥ 60% are positive prognostic biomarkers.

77 NM patients were identified via cytopathology and their primary cancer, presenting symptoms, age and KPS at diagnosis, and length of survival after diagnosis were entered into the registry. Analysis of their data was then performed to validate data and identify biomarkers.

Lymphoma was the most common primary cancer (26%), followed by breast (21%), ALL (12%), AML (9%) and lung (7%). The most common presenting symptoms were headache (16%), motor weakness (13%), gait abnormalities (11%), visual disturbances (11%), and sensory deficits (9%). Median age and KPS at diagnosis were 58 (range 18-83) and 60% (range 10-100%), respectively. Median overall survival (OS) was 3.55 months (range 0-130.45 months). An important prognostic biomarker was a higher KPS (≥ 60% vs. < 60%), which was associated with an improved median OS (5.84 vs 1.28 months). Further, younger age (< 55 vs ≥ 55 years) was associated with an improved median OS (3.91 vs 3.17 months).

Our results support prior findings that KPS ≥ 60 and age < 55 years are associated with improved median OS—validating both as survival biomarkers. Also, headache coupled with visual disturbance was the most common presentation, which may be a novel biomarker for diagnosing NM in patients with known malignancies.