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Fig 1.

MR image before and after shunt surgery.

(A) MR image shows linear enhancement along the cerebellar folia. (B) FLAIR image obtained prior to VP shunt shows enlarged lateral ventricles with periventricular high intensity. (C) FLAIR image after VP shunt shows decreased size of the lateral ventricles and improved periventricular high intensity three months after shunting.

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Table 1.

Characteristics of patients with CSF shunting for LM-H from lung adenocarcinoma.

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Table 1 Expand

Fig 2.

Kaplan-Meier survival curves showing OS from the diagnosis of LM (LM-OS).

(A) Median OS from the diagnosis of LM-H (LM-OS) in patients with ECOG performance status (PS) less than 2 at the diagnosis of LM was 7.7 months, and this was significantly longer than those in patients with PS 3 or 4 (4.4 or 1.5 months, respectively; p<0.001). (B) Patients with EGFR sensitive mutation showed longer LM-OS than those with EGFR wild type (5.0 vs. 3.6 months, respectively; p = 0.019).

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Fig 3.

Kaplan-Meier survival curves showing OS from the diagnosis of LM (LM-OS).

(A) Patients with good control of extracranial disease showed prolonged LM-OS compared with the progressive extracranial disease group (9.6 vs. 4.2 months, respectively; p = 0.015). (B) Patients receiving systemic EGFR-TKI treatment after CSF shunt showed prolonged LM-OS compared with the no TKI group (7.0 vs. 3.6 months, respectively; p = 0.0001).

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Fig 4.

Kaplan-Meier survival curves showing OS from the diagnosis of LM (LM-OS) (a) and OS from CSF shunting (S-OS) (b).

(A) There was no significant difference in LM-OS between patients who did or did not receive radiotherapy (4.0 vs. 3.5 months, respectively; p = 0.739). (B) There was no significant difference in OS from shunt surgery between patients who underwent VP shunt and LP shunt procedures (3.9 vs 3.5 months, respectively; p = 0.596).

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Fig 5.

ECOG performance status comparison before vs. after shunt surgery.

Remarkable improvements in ECOG PS after shunt surgery.

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Table 2.

Cox regression analysis of potential prognostic factors.

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Table 2 Expand