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Ventriculoperitoneal Shunt for CNS Metastasis in Breast Cancer: Clinical Outcomes Based on Intrinsic Subtype

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Author(s)
Hee Kyung KimHan Sang LeeMi Hwa HeoJi-Yeon KimJin Seok AhnYoung-Hyuck ImJung-Il LeeYeon Hee Park
Keimyung Author(s)
Heo, Mi Hwa
Department
Dept. of Internal Medicine (내과학)
Journal Title
Clin Breast Cancer
Issued Date
2021
Volume
21
Issue
4
Keyword
Breast cancer subtypeLeptomeningeal metastasisMetastatic breast cancerOverall survivalVP shunt
Abstract
Background:
Leptomeningeal metastasis (LM) is associated with a grave prognosis in breast cancer (BC) and can be controlled with a ventriculoperitoneal shunt (VPS). Information regarding LM and VPS based on intrinsic subtype is limited; thus, we investigated the clinical outcomes of BC treated with VPS.

Patients and Methods:
The present retrospective study comprised 70 patients diagnosed with LM who received a VPS. The patients were divided into 4 groups based on BC subtype: hormone receptor (HR) + /human epidermal growth factor receptor 2 (HER2) − , HR + /HER2 + , HR − /HER2 + , and triple negative BC (TNBC).

Results:
The most common indications for VPS were uncontrolled intracranial pressure (57.1%) and uncontrolled headache (55.7%), which improved in 54 (77.1%) of 70 patients after VPS. The median overall survival (OS) after brain or LM and overall survival after VPS were 7.6 and 2.3 months, respectively. Anti-HER2 treatment was a significant prognostic factor for better OS after brain or LM based on multivariate analysis (hazard ratio, 0.15; 95% confidence interval, 0.04-0.57; P = .005), whereas TNBC was correlated with shorter OS after central nervous system metastasis (hazard ratio, 2.82; 95% confidence interval, 1.46-5.48; P = .002).

Conclusions:
There were significant differences in clinical outcome based on the intrinsic subtype of patients with BC with LM who received a VPS. Anti-HER2 treatment in patients with HER2 + BC was associated with better survival in patients with metastatic BC with VPS insertion compared with those without. Survival of metastatic BC with VPS remained poor, especially in the TNBC subgroup.
Keimyung Author(s)(Kor)
허미화
Publisher
School of Medicine (의과대학)
Citation
Hee Kyung Kim et al. (2021). Ventriculoperitoneal Shunt for CNS Metastasis in Breast Cancer: Clinical Outcomes Based on Intrinsic Subtype. Clin Breast Cancer, 21(4), e402–e414. doi: 10.1016/j.clbc.2020.12.013
Type
Article
ISSN
1938-0666
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S152682092100001X
DOI
10.1016/j.clbc.2020.12.013
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43700
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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