The rates of survival for neoplastic meningitis varies depending on the source of primary tumor, but generally median survival rate without treatment is limited to 1 to 2 months. With treatment, this could extend to 2 to 5 months for breast cancer, 3 to 6 months for non-small cell lung cancer and 2 to 4 months for melanoma. Factors affecting the prognosis of patients with neoplastic meningitis includes gene involvement and use of immunotherapy and other targeted therapies. For breast cancer, ER-positivity, lesser extend of initial disease and better performance status has been demonstrated to have better prognosis. For lung cancer, the use of epidermal growth factor (EGFR) inhibitors confers durable responses without the need for intra-CSF chemotherapy administration. Lastly, for melanoma, primary tumors located in the trunk has been documented to have a poor prognosis, but intra-CSF administration of chemotherapy significantly improves this prognosis.  Not surprisingly, patients with poor performance status, multiple fixed neurological deficits, bulks CNS disease, co-existent carcinomatous encephalopathy and CSF flow abnormalities will do poorly with intensive treatment of disease. Death typically results from progression of neurological dysfunction.  Some retrospective studies have demonstrated favorable outcomes in neoplastic meningitis: age less than 60, long duration of symptoms, controlled systemic disease, Karnofsky performance status >/= 70, absence of encephalopathy or cranial nerve deficit, initially low CSF protein level, absence of CSF compartamentalization or bulky CNS disease manifested by impedance of CSF flow and history of primary breast tumor.
What to expect if I have Neoplastic meningitis  (Outlook/Prognosis)?
The rates of survival for neoplastic meningitis varies depending on the source of primary tumor, but generally median survival rate without treatment is limited to 1 to 2 months. With treatment, this could extend to 2 to 5 months for breast cancer, 3 to 6 months for non-small cell lung cancer and 2 to 4 months for melanoma. Factors affecting the prognosis of patients with neoplastic meningitis includes gene involvement and use of immunotherapy and other targeted therapies. For breast cancer, {{ORGANIZATION}}-positivity, lesser extend of initial disease and better performance status has been demonstrated to have better prognosis. For lung cancer, the use of epidermal growth factor (EGFR) inhibitors confers durable responses without the need for intra-CSF chemotherapy administration. Lastly, for melanoma, primary tumors located in the trunk has been documented to have a poor prognosis, but intra-CSF administration of chemotherapy significantly improves this prognosis.  Not surprisingly, patients with poor performance status, multiple fixed neurological deficits, bulks {{ORGANIZATION}} disease, co-existent carcinomatous encephalopathy and {{ORGANIZATION}} flow abnormalities will do poorly with intensive treatment of disease. Death typically results from progression of neurological dysfunction.  Some retrospective studies have demonstrated favorable outcomes in neoplastic meningitis: age less than 60, long duration of symptoms, controlled systemic disease, {{NAME}} performance status >/= 70, absence of encephalopathy or cranial nerve deficit, initially low {{ORGANIZATION}} protein level, absence of {{ORGANIZATION}} compartamentalization or bulky {{ORGANIZATION}} disease manifested by impedance of {{ORGANIZATION}} flow and history of primary breast tumor.