Development of leptomeningeal carcinomatosis (LC) in advanced prostate cancer patients: Characteristics of six cases in a single institution.
Bibliographic record
Abstract
218 Background: In the past months, we have noticed an increasing number of leptomeningeal carcinomatosis (LC) in patients known for advanced prostate cancer (PC). This complication has only been reported in a few patients. Methods: We identified and reviewed the charts of all patients known for advanced PC who later developed LC. We report their characteristics as well as survival. Results: Between March 2009 and April 2010, we identified 6 patients known for advanced PC that showed evidence of LC (median time from diagnosis of prostate cancer to development of LC, 55.8 months). Disease was already metastatic to other sites in all of them, and all had previously showed evidence of castrate refractory prostate cancer (CRPC). All patients maintained LHRH agonist therapy and were treated with prednisone once they showed evidence of CRPC. Most had also been treated with docetaxel (n=5), zoledronic acid (n=4; the remaining 2 patients received either zoledronic acid or denosumab as part of a protocol) and/or other (dasatinib/placebo as part of a protocol, n=1; sunitinib as part of a protocol, n=1). LC was diagnosed a median of 21.2 months after evidence of CRPC, based on clinical findings (cranial nerve[s] involvement [n=6] and nausea and/or ataxia [n=2]) and magnetic resonance imaging (MRI). 2 patients underwent lumbar puncture (negative results). Treatment administered for LC included dexamethasone (n=1), radiation therapy (n=1), or both (n=2). Two patients with poor performance status did not receive any treatment. All patients assessable for response (n=3) showed a partial improvement in their symptoms, but not complete resolution. Median overall survival from development of CRPC and from diagnosis of LC is 23.9 months and 2.7 months, respectively. Conclusions: LC is a newly described site of metastasis in patients with advanced CRPC. It is associated with a late onset and a very poor prognosis. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".