Abstract
Dural-based metastases (DBM) are present in 4% of all patients diagnosed with metastatic cancer. DBM most commonly arise from primary cancers of the lung, breast, and prostate. While diagnostic challenges are relatively well studied, the epidemiology, common intracranial locations, and therapeutic outcomes of DBM remain poorly understood. Our current study aims to define the epidemiological characteristics of patients presenting with DBM, the most common locations of metastasis within the dura, and clinical outcomes after surgery and radiation therapy.
Patients presenting to the Montreal Neurological Institute for intracranial metastasis between the years 2010 and 2016 were reviewed, and patients with DBM were identified based on radiological characteristics. Data were extracted from patient charts and MRIs.
A total of 46 patients met inclusion criteria and were included in the study. The mean age at DBM diagnosis was 57 years old. Lung cancer was the most common origin (57%), while breast cancer was the second most common (22%). DBM were more likely to present in patients with active systemic disease (63%) and were found within 1 cm of a major venous sinus in 52% of cases. 87% of patients underwent gross total resection of their tumors. In these patients, adjuvant SRS was associated with a 2-fold increase in mean survival time (p = 0.013).
Although DBM are a marker of advanced systemic cancer, surgical resection with adjuvant radiotherapy may play a role in control of intracranial disease and overall patient survival.