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Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.017
vdae090.017
Final Category: Basic Science Leptomeningeal Disease
AcademicSubjects/MED00300
AcademicSubjects/MED00310
BSLM-06 PROGNOSTIC SIGNIFICANCE OF CEREBROSPINAL FLUID GLUCOSE AND PROTEIN LEVELS IN METASTATIC BREAST CANCER PATIENTS WITH LEPTOMENINGEAL DISEASE: A RETROSPECTIVE STUDY
Niraula Sujan Vassar Brother Medical Center, Nuvance Health, Poughkeepsie/NY, USA

Gauli Sugam Rochester General Hospital, Rochester/NY, USA

Baran Andrea M University of Rochester, Rochester/NY, USA

Tyburski Haley University of Rochester, Rochester/NY, USA

Zhang Huina University of Rochester Medical Center, Rochester/NY, USA

O’Regan Ruth University of Rochester Medical Center, Rochester/NY, USA

Mohile Nimish University of Rochester Medical Center, Rochester/NY, USA

Anders Carey K Duke Cancer Institute, Durham/NC, USA

Hardy Sara University of Rochester Medical Center, Rochester/NY, USA

Dhakal Ajay University of Rochester Medical Center, Rochester/NY, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i6i6
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

The prognostic significance of cerebrospinal fluid (CSF) glucose and protein levels among patients with leptomeningeal disease (LMD) is unknown. This single-institution retrospective study aims to investigate the association of CSF glucose and protein levels with overall survival (OS) among metastatic breast cancer (MBC) patients with LMD.

METHODOLOGY

MBC patients diagnosed with LMD between Jan 1st, 2010, and Jan 1st, 2023, were included. Patients without known CSF glucose or protein levels at the time of LMD diagnosis were excluded. OS was evaluated using the Kaplan-Meier method and compared using the log-rank test. For multivariate analysis, a step-wise model selection was performed after the inclusion of sub-type of interest, and variables meeting entry (p<0.10) and staying criteria (p<0.05). Median glucose and protein levels were compared using the Wilcoxon rank-sum test.

RESULTS

28 patients met inclusion criteria. Positive CSF cytology samples (CSF+) had significantly lower glucose levels vs CSF cytology negative samples (CSF-) [median (IQR) 40 (18-58) vs. 64 (53-92) mg/dl, p=0.006]. Prior study from this data set had shown that the CSF- group was associated with better OS vs the CSF+ group. Hence, four groups were created based on the CSF (+/-) and glucose (Low vs High/Normal). Median OS (months), 95% confidence Interval (CI) for CSF+/Glucose_Low, CSF+/Glucose_Normal/High, CSF-/Glucose_Low and CSF-/Glucose_High/Normal were 3.4(0.23-NE), 16.5(2.9-NE), 3.1(1.28-NE), 51.5(4.9-NE), p=0.03. Glucose_Low overall was associated with shorter OS in multivariate analysis [hazard ratio (HR), 95%CI 4.64 (1.71, 13.2)]. Median CSF protein was not different between CSF+/– groups. Median OS (months), 95%CI for Protein_High and Protein_Low /Normal groups were 28.5 (2.9, 51.5) vs. 6.5 (0.85, 8.0), p=0.36. In multivariate analysis, CSF protein level was not associated with OS.

CONCLUSION

The association between low CSF glucose level and worse survival among patients with MBC LMD was observed.
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