Leptomeningeal disease (LMD) after resection of brain metastases: results of the multicenter SUBAROMA study.

Authors

Laura Mühlhausen, Martin Kocher, Hanah Hadice Karadachi, Ulrich Sure, Yahya Ahmadipour, Levin Häni, Danial Nasiri, Tommaso Araceli, Martin Proescholdt, Nils Ole Schmidt, Andrea Cattaneo, Vera Nickl, Florian Scheichel, Franz Marhold, Stefan J Grau, Christina A Hamisch, Franz L Ricklefs, Yahya Zghaibeh, Roland H Goldbrunner, Stephanie T Jünger

Published in

Journal of neuro-oncology. Volume 178. Issue 3. Jul 10, 2026. Epub Jul 10, 2026.

Abstract

To identify risk factors for development of leptomeningeal disease (LMD) in patients with resected brain metastases (BM) based on the multicentric SUBARoMA study-cohort.
The SUBARoMA study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.
We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (p = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (p = 0.002), while postoperative systemic therapy (p < 0.001) represented a protective factor. Incomplete resection (p = 0.003; HR 1.810; 95%CI 1.218-2.690) and postoperative systemic therapy (p = 0.028; HR 0.641; 95%CI 0.431-0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.
Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.

PMID:
42429857
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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