Distribution of metastatic disease in the brain in relation to the hippocampus: a retrospective single-center analysis of 6064 metastases in 632 patients

Abstract

This study aimed to investigate the patterns of brain metastasis and to explore the risk factors affecting hippocampus metastasis (HM). We retrospectively analyzed the clinical information of patients with metastatic disease in the brain. The associations between clinicopathologic variables with HM and peri-hippocampal metastasis (PHM) were evaluated in univariate and multivariate regression analyses. A total of 632 patients with 6064 metastatic lesions were recruited into the present study. Of these, 4.1% (26/632) of patients developed HM, and 5.5% (35/632) of patients developed PHM. Only 0.5% (31/6064) of metastatic lesions were located in the hippocampus and 0.6% (37/6064) were in the PHM. Age ≤60 years was an independent risk factor for HM (odds ratio [OR]: 2.602, 95% confidence interval [CI]: 1.115–6.076, P = 0.027) and PHM (OR: 2.555, 95%CI: 1.229–5.310, P = 0.012) in univariate and multivariate analyses. The hippocampus is a rare site of brain metastasis. Younger patients (age ≤60 years) had increased risk of developing HM and PHM. The current study provides the opportunity to investigate the clinical feasibility of hippocampal sparing whole brain radiation therapy, especially in older patients.

Clinical features of brain metastases in breast cancer: an implication for hippocampal-sparing whole-brain radiation therapy

“…In this study, we identified patients from two cancer centers, and the probabilities of HM (3.6%) and PHM (7.3%) were not significantly higher than the previous results (4.1% of patients developed HM and 5.5% of patients developed PHM in our previous study) 11. In a previous study of 314 Chinese patients, the percentages of HM and PHM were 4.1% and 11.1%, respectively 10.…”

“…Our previous single center study of 56 breast cancer patients observed an increase in risk of PHM relative to patients with other types of cancers, although the association was not statistically significant ( P =0.084) 11. In this study, we identified patients from two cancer centers, and the probabilities of HM (3.6%) and PHM (7.3%) were not significantly higher than the previous results (4.1% of patients developed HM and 5.5% of patients developed PHM in our previous study) 11.…”

“…However, this study was limited by a small sample size of breast cancer patients 15. In a previous study, we reported a potential increase in hippocampal metastases (HM) and perihippocampal metastases (PHM) in breast cancer patients (n=56), relative to other malignant tumors 11. In this study, we collected data from two academic cancer centers for further analysis of HM and PHM in breast cancer patients to investigate potential risk factors for PHM.…”

Clinical Features of Brain Metastases in Small Cell Lung Cancer: an Implication for Hippocampal Sparing Whole Brain Radiation Therapy

“…The results of the RTOG 0933 trial showed that the decrease of the neurocognitive function from baseline to 4 months in the HS-WBRT group was significantly lower than that in the historical control group (7.0% vs 30.0%, P  < .001) [15]. Despite the potential to disseminate to the brain, the incidence of HMs and PHMs in patients with SCLC is not significantly higher than other malignant tumors [18], [19], [20], [24], [25]. Therefore, HS-WBRT in patients with SCLC is also feasible.…”

Innovations in Metastatic Brain Tumor Treatment

“…Cerebellar metastases make up approximately 18% of BM. The least common area is the brainstem [26,29,30]. Studies have suggested that the sites of BMs vary based on the primary site of origin and cerebral blood flow.…”