Describing Symptom Burden and Functional Status at the Diagnosis of Leptomeningeal Metastasis.

The study reviewed old medical records, so symptom and functional status data were limited by what had been recorded. Symptoms were recorded only as present or absent, not how severe they were. Thirty-one patients had no recorded Karnofsky Performance Status score, and the investigator estimated those scores from chart notes. The sample was small and included only patients who were presenting for treatment at a single center, so patients with worse function or more disease may have been left out. Most patients were women with breast cancer, and this makes gender findings hard to interpret. No instrument has been validated specifically for leptomeningeal metastasis symptoms, and neither MDASI-BT nor MDASI-SP has been validated in this population. Formal neurocognitive testing was not done, so cognitive symptoms were described only from chart notes.

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Do not read the lower symptom counts with biotherapy six months or less before diagnosis, or the higher counts with hormonal ablation therapy six months or less before diagnosis, as proof that these treatments changed symptom burden. This was a retrospective chart review without assigned treatment, and symptoms were recorded only as present or absent.