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

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 (P50.009) among BC diagnosis features. Among MC diagnosis parameters, more than three metastases at diagnosis (P50.037), multimodality treatment (P50.014) and poor performance status (P50.003) reached the statistical significance. At multivariate analysis only performance status at MC diagnosis maintained the statistical significance (P50.0047; 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.