Introduction: Placement of an Ommaya reservoir allows for the delivery of intrathecal chemotherapeutic agents to patient with metastatic disease to the central nervous system. Our objective was to determine post-operative survival length. We also sought to elucidate patient characteristics that may favor longer post-operative survival. Finally, we aimed to describe post-operative complications and mortality.
Methods: The authors performed a retrospective review of all patients that had an Ommaya reservoir placed at Fletcher Allen Health Care in Burlington, Vermont over an eleven year period. The primary outcome of interest was length of survival after surgery. Statistical analysis was performed to determine factors that may influence this primary outcome. Secondary characteristics that were analyzed included peri-operative mortality and procedure complications.
Results: A total of 39 patients were identified with an overall median survival of 46 days. The most common malignancies included non-Hodgkin's lymphoma, lung, acute lymphoblastic leukemia, and breast cancer. The median survival of patient with non-Hodgkin's lymphoma was significantly longer than the other three diagnosis groups (122 days, p=0.03). A trend for longer survival was noted in younger patients (less than 60) and male patients. Peri-operative mortality was 36%.
Conclusions: The overall median survival after Ommaya placement was 46 days, with a peri-operative mortality of 36%. Patients with Non-Hodgkin's lymphoma demonstrated statistically significant longer survival intervals than any other group.
Patient Care: Understanding influencing factors on survival length, post-operative complications, and peri-operative mortality associated with Ommaya placement can be used to counsel patients when considering intraventricular chemotherapy.
Learning Objectives: 1. Determine post-operative survival length after placement of an Ommaya reservoir
2. Elucidate patient characteristics that may favor longer post-operative survival.
3. Describe post-operative complications and mortality.