Can vascular risk factors influence number and size of cerebral metastases? A 3D-MRI study in patients with different tumor entities

Clin Neurol Neurosurg. 2018 Feb:165:55-59. doi: 10.1016/j.clineuro.2018.01.001. Epub 2018 Jan 2.

Abstract

Objective: There is increasing evidence that cerebral microangiopathy reduces number of brain metastases. Aim of this study was to analyse if vascular risk factors (arterial hypertension, diabetes mellitus, smoking, and hypercholesterolemia) or the presence of peripheral arterial occlusive disease (PAOD) can have an impact on number or size of brain metastases.

Patients and methods: 200 patients with pre-therapeutic 3D-brain MRI and available clinical data were analyzed retrospectively. Mean number of metastases (NoM) and mean diameter of metastases (mDM) were compared between patients with/without vascular risk factors (vasRF).

Results: No general correlation of vascular risk factors with brain metastases was found in this monocentric analysis of a patient cohort with several tumor types. Arterial hypertension, diabetes mellitus, hypercholesterolemia and smoking did not show an effect in uni- and multivariate analysis. In patients with PAOD the number of BM was lower than without PAOD. This was the case independent from cerebral microangiopathy but did not persist in multivariate analysis.

Conclusion: From this first screening approach vascular risk factors do not appear to strongly influence brain metastasation. However, larger prospective multi-centric studies with better characterized severity of vascular risk are needed to more accurately detect effects of individual factors.

Keywords: Brain metastasis; Cerebral microangiopathy; Leukoaraiosis; NSCLC; Peripheral artery occlusive disease; Vascular risk factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arterial Occlusive Diseases / complications*
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology*
  • Diabetes Complications
  • Diabetes Mellitus / pathology
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / complications
  • Retrospective Studies
  • Risk Factors
  • Supratentorial Neoplasms / pathology*