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@ARTICLE{Alhalabi:301771,
      author       = {O. T. Alhalabi and L. Klein and D. Wasilewski and A. Mellal
                      and C. Büsken and C. Buszello and G. Cossu and I. Y.
                      Eyüpoglu and A. W. Unterberg and P. Vajkoczy and G.
                      Schackert and M. Messerer and M. Misch and T. Kessler$^*$
                      and W. Wick$^*$ and C. Jungk and A. El Damaty and S. M.
                      Krieg and T. A. Juratli and A. Younsi},
      title        = {{M}anaging hydrocephalus in patients with leptomeningeal
                      disease: {A} multicenter retrospective analysis.},
      journal      = {International journal of cancer},
      volume       = {157},
      number       = {8},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2025-01151},
      pages        = {1613-1624},
      year         = {2025},
      note         = {2025 Oct 15;157(8):1613-1624},
      abstract     = {Leptomeningeal disease (LMD) represents a terminal
                      condition of tumor cell seeding that can cause symptomatic
                      hydrocephalus. With improved survival rates under systemic
                      therapy, the role of cerebrospinal fluid (CSF) drainage
                      through ventriculo-peritoneal shunt (VPS) or Rickham
                      reservoir (RR) placement in LMD patients is gaining more
                      relevance. This study aimed to compare outcomes of both
                      modalities in a multicentric contemporary cohort. A
                      retrospective analysis of medical charts in patients
                      receiving VPS for LMD and malresorptive hydrocephalus in two
                      neurosurgical centers between 2006 and 2021 yielded 64
                      patients. The most common underlying oncological conditions
                      were breast (n = 32, $49\%)$ and non-small cell lung cancer
                      (NSCLC, n = 16, $25\%).$ The median time between primary and
                      LMD diagnosis was 23.3 months (11.2 to 43.4 months).
                      Symptoms of intracranial hypertension were relieved in
                      $79\%$ of cases (n = 50) after shunting, with 42 $(66\%)$
                      and 32 patients $(50\%)$ receiving systemic and intrathecal
                      therapy, respectively. A further multicenter analysis
                      comparing patients receiving VPS with patients receiving RR
                      (with regular tapping) included 155 patients (VPS: n = 80,
                      $52\%;$ RR: n = 75, $48\%).$ Compared to VPS, RRs were
                      associated with a lower surgical revision rate $(8\%$ vs.
                      $24\%,$ p = 0.009). There was no difference in median
                      overall survival in VPS patients (118 days) compared to RR
                      patients (80 days, p = 0.180). Given this data showing a
                      short and comparable survival of patients under both
                      modalities with a lower RR complication rate, a rationale
                      for an initial Rickham implantation in LMD patients with
                      hydrocephalus, with later VPS conversion for long-term
                      surviving patients, could be contemplated.},
      keywords     = {CSF diversion (Other) / Rickham reservoir (Other) /
                      intrathecal therapy (Other) / leptomeningeal disease (Other)
                      / ventriculoperitoneal shunt (Other)},
      cin          = {B320},
      ddc          = {610},
      cid          = {I:(DE-He78)B320-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40464488},
      doi          = {10.1002/ijc.35505},
      url          = {https://inrepo02.dkfz.de/record/301771},
}