{"id":"d0fb9961-1630-4603-b471-cde172f7ede2","slug":"different-methods-of-cerebrospinal-fluid-diversion-in-patients-with-leptomeningeal-metastasis-a-systematic-review-and-meta-analysis","title":"Different methods of cerebrospinal fluid diversion in patients with leptomeningeal metastasis: A systematic review and meta-analysis","authors":["Vega Pangaribuan","Muhammad Arifin Parenrengi","Wihasto Suryaningtyas","Asra Al Fauzi","Achmad Fahmi","Budi Utomo","Rahadian Indarto Susilo"],"abstract":"Background: Leptomeningeal metastasis (LM) is one of the complications of primary malignancies, particularly in solid tumors. The consequence of LM is increased intracranial pressure (ICP) or secondary hydrocephalus. The most frequent method for diverting cerebrospinal fluid (CSF) in this group is a ventriculoperitoneal shunt (VPS); however, the capability of CSF diversion in improving patients’ survival has been debatable. There is currently no established protocol for treating LM patients with elevated ICP. Methods: We searched for studies involving patients with LM who underwent CSF diversion in multiple search databases. The search flow followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol criteria. Results: This review includes a total of 15 studies. The average age at diagnosis was 55.3 ± 3.9 years. Among 415 patients, lung cancer was the most frequent primary malignancy. Overall symptom improvement from CSF diversion is 86% (95% confidence interval [CI]: 0.79–0.92). Complication rate among patients who had permanent CSF diversion is 18% (95% CI: 0.11.24). Overall survival in the LM population can be improved by permanent CSF diversion (P < 0.05). The superiority of the lumboperitoneal shunt over VPS in improving survival is yet to be determined due to a lack of statistically significant findings. Although the use of permanent CSF diversion in conjunction with reservoir devices is increasing, its superiority in improving survival has not yet been established. Conclusion: This review demonstrated that patients with LM may benefit from a higher chance of survival with permanent CSF diversion. Further research is required to determine the role of various CSF diversion methods in improving survival.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/d0fb9961-1630-4603-b471-cde172f7ede2/featured/hero-1781558122533.png","publishDate":"2025-12-12T00:00:00.000Z","doi":"10.25259/SNI_884_2025","categories":["Neuro-oncology","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2025/12/14134/SNI-16-528.pdf"}