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LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), interval between BM and PT diagnosis\u2009\u2265\u20093 months, and incomplete resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), while postoperative systemic therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) represented a protective factor. Incomplete resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003; HR 1.810; 95%CI 1.218\u20132.690) and postoperative systemic therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028; HR 0.641; 95%CI 0.431\u20130.952) remained independent risk\/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breast cancer, melanoma, incomplete resection and BM occurrence\u2009\u2265\u20093months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05700-6","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:27:37Z","timestamp":1783675657000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leptomeningeal disease (LMD) after resection of brain metastases: results of the multicenter SUBAROMA study"],"prefix":"10.1007","volume":"178","author":[{"given":"Laura","family":"M\u00fchlhausen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kocher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanah Hadice","family":"Karadachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Sure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya","family":"Ahmadipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levin","family":"H\u00e4ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danial","family":"Nasiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Araceli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Proescholdt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils Ole","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cattaneo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Nickl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Scheichel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Marhold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan J.","family":"Grau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Hamisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz L.","family":"Ricklefs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya","family":"Zghaibeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland H.","family":"Goldbrunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-8204","authenticated-orcid":false,"given":"Stephanie T.","family":"J\u00fcnger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"1","key":"5700_CR1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s11912-011-0203-y","volume":"14","author":"L Nayak","year":"2012","unstructured":"Nayak L, Lee EQ, Wen PY (2012) Epidemiology of brain metastases. 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