Seasonal variability in the incidence of carcinomatous meningitis

Abstract

OBJECT The aim of the study was to investigate whether there are seasonal differences in the occurrence of carcinomatous meningitis (CM), with a greater prevalence of the disease in months with higher temperatures. METHODS The authors searched the records of all patients with a diagnosis of CM from 1998 until 2013 at the University Hospital of Patras, Greece. The date of hospitalization was extracted for each patient. The cases were divided into 2 categories depending on the time of CM diagnosis. Based on the official data regarding the annual temperature distribution in this region, the authors divided the patients into 2 groups. The first group consisted of cases diagnosed with CM from October 15 to April 15 (cold climate and shorter daytime duration), whereas the second group comprised patients diagnosed between April 15 and October 15 (warm climate and longer daytime duration). RESULTS Overall, 44 confirmed cases of CM were found. The most common type of malignancy associated with the development of CM was breast cancer (27 patients), while the second most common tumor was lung carcinoma (11 patients). The median interval between the time of initial cancer diagnosis and CM was 4.5 years. Thirty-one patients were diagnosed with CM during the period between April 15 and October 15, while the remaining 13 patients developed CM between October 15 and April 15, a significant difference (p = 0.01). CONCLUSIONS Significantly more patients developed CM during the warm season of the year. To the authors' knowledge, this is the first study to provide evidence for the potential seasonal variability in CM incidence. However, these results should be validated prospectively in larger cohorts.

Assessment of the “July Effect”: outcomes after early resident transition in adult neurosurgery

“…Another benefit of not including Q2 or Q3 is that seasonal trends in outcomes during winter months have been described for certain conditions, such as subarachnoid hemorrhage and carcinomatous meningitis, which may have otherwise confounded our results. 10,13 All neurosurgical cases in the given time intervals for which residents were members of the neurosurgical team were included in the study. Cases in which residents did not provide surgical assistance were excluded; these cases were defined as those in which "Attending Alone" was indicated for the ATTEND variable or 0 (zero) for the PGY (Postgraduate Year) variable.…”

Identification of a seasonal pattern to brain metastases.

“…We have previously tested our hypothesis that there is a seasonality in the incidence of carcinomatous meningitis. 1 Although further validation is needed in a larger cohort, we found that leptomeningeal metastasis occurred more often during warm months of the year which, in the case of Greece, is the period generally marked with the larger daytime length. 1 Carcinomatous meningitis is closely related to brain metastasis, and a logical question is whether warm season is marked by a greater propensity also for brain metastasis.…”

“…1 Although further validation is needed in a larger cohort, we found that leptomeningeal metastasis occurred more often during warm months of the year which, in the case of Greece, is the period generally marked with the larger daytime length. 1 Carcinomatous meningitis is closely related to brain metastasis, and a logical question is whether warm season is marked by a greater propensity also for brain metastasis. 2 We conducted a single-center retrospective review of the medical records of patients with brain metastases that received whole brain irradiation from 2008 to 2013 (6 years).…”

Cancer and Ongoing Climate Change: Who Are the Most Affected?

“…With the accumulation of greenhouse gases, global warming, and changing meteorological factors, there is an increasing frequency of abnormally hot and cold temperatures, which are the direct expression of climate variability. Although it is not clear whether it is the increased temperature of warm months, carcinomatous meningitis was observed to have a higher incidence in these months . Evidence from more studies is warranted to confirm the causal association.…”

“…Although it is not clear whether it is the increased temperature of warm months, carcinomatous meningitis was observed to have a higher incidence in these months. 14 Evidence from more studies is warranted to confirm the causal association. The direct effects of extreme temperatures like heat waves may worsen the conditions of cancer patients because of their impaired thermoregulation and immune function.…”