NDLI: Survival following Ommaya reservoir placement for neoplastic meningitis.

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Survival following Ommaya reservoir placement for neoplastic meningitis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Roguski, Marie Rughani, Anand Lin, Chih-Ta Cushing, Deborah A. Florman, Jeffrey E. Wu, Julian K.
Description	Country affiliation: United States Author Affiliation: Roguski M ( Department of Neurosurgery, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.); Rughani A ( Neuroscience Institute, Maine Medical Center, Portland, ME, USA.); Lin CT ( Division of Neurosurgery, University of Vermont, Medical Center, Burlington, VT, USA.); Cushing DA ( Neuroscience Institute, Maine Medical Center, Portland, ME, USA.); Florman JE ( Neuroscience Institute, Maine Medical Center, Portland, ME, USA.); Wu JK ( Department of Neurosurgery, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA. Electronic address: jwu3@tuftsmedicalcenter.org.)
Abstract	The objective of this study was to evaluate the outcomes of patients with neoplastic meningitis (NM) following Ommaya reservoir placement in order to determine whether any patient factors are associated with longer survival. NM is a devastating late manifestation of cancer, and given its dismal prognosis, identifying appropriate patients for Ommaya reservoir placement is difficult. The authors performed a retrospective review of 80 patients who underwent Ommaya reservoir placement at three medical centers from September 2001 through September 2012. The primary outcome was death. Differences in survival were assessed with Kaplan-Meier survival analyses. The Cox proportional hazards and logistic regression modeling were performed to identify factors associated with survival. The primary diagnoses were solid organ, hematologic, and primary central nervous system tumors in 53.8%, 41.3%, and 5%, respectively. The median overall survival was 72.5 days (95% confidence interval 36-122) with 30% expiring within 30 days and only 13.8% surviving more than 1 year. There were no differences in median overall survival between sites (p=0.37) despite differences in time from diagnosis of NM to Ommaya reservoir placement (p<0.001). Diagnosis of hematologic malignancy was inversely associated with death within 90 days (p=0.04; odds ratio 0.34), older age was associated with death within 90 days (p=0.05; odds ratio 1.5, per 10 year increase in age). The prognosis of NM remains poor despite the available treatment with intraventricular chemotherapy. There exists significant variability in treatment algorithms among medical centers and consideration of this variability is crucial when interpreting existing series of Ommaya reservoir use in the treatment of patients with NM.
File Format	HTM / HTML
ISSN	09675868
Issue Number	9
Volume Number	22
e-ISSN	15322653
Journal	Journal of Clinical Neuroscience
Language	English
Publisher	Elsevier
Publisher Date	2015-09-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medicine Antineoplastic Agents Administration & Dosage Drug Delivery Systems Infusions, Intraventricular Meningeal Carcinomatosis Surgery Adult Aged Aged, 80 And Over Female Humans Kaplan-meier Estimate Male Mortality Middle Aged Prognosis Proportional Hazards Models Prostheses And Implants Retrospective Studies Journal Article
Content Type	Text
Resource Type	Article
Subject	Neurology Physiology (medical) Neurology (clinical) Surgery

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