OUTCOME OF PERONEAL NEUROPATHIES IN PATIENTS WITH SYSTEMIC MALIGNANT DISEASE

BACKGROUND. Peroneal neuropathies in patients with systemic cancer pre viously, have been attributed to weight loss, but to the authors' know ledge other associated conditions have not been assessed, and the outc ome of peroneal neuropathies in cancer patients has not been studied. METHODS. A retrospective chart review of patients evaluated at the May o Clinic between 1984 and 1993 with systemic malignant disease and a c linical diagnosis of peroneal neuropathy was performed to define facto rs associated with peroneal neuropathies and to assess outcome. All pa tients underwent neurologic examination and electromyography. RESULTS. Fifty-eight patients with systemic malignant disease were found to ha ve a peroneal neuropathy. Peroneal neuropathies occurred more often in men (45 patients) than in women (13 patients). The median age of the patients was 70 years. The most common cancers were hematologic (12 pa tients) and pulmonary (11 patients), followed by tumors of the prostat e (8 patients), gastrointestinal tract (7 patients), transitional cell (5 patients), breast (5 patients), and colon (5 patients), as well as sarcomas and melanoma (5 patients). The median time to the diagnosis of peroneal neuropathy after the diagnosis of cancer was 5 months. At the time of diagnosis, 34 patients had severe deficits, 19 had moderat e deficits, and 5 had mild deficits. Associated factors included weigh t loss (occurring in 60% of patients), leg crossing (35% of patients), recent chemotherapy (16% of patients), cutaneous vasculitis (5% of pa tients), and local metastatic lesions (3% of patients). In nearly 50% of patients, peroneal neuropathy improved (25.9%) or resolved (22.4%). In 39.7% of patients, follow-up was inadequate because death occurred soon after diagnosis. Of the patients with adequate follow-up before death, 80% had either improvement (42.9%) or resolution (37.1%). CONCL USIONS. For those patients with systemic malignant disease in whom per oneal neuropathy develops, the outcome of the neuropathy is good, with the majority of patients achieving partial or complete resolution. Ca ncer 1998;83: 1602-6. (C) 1998 American Cancer Society.