Dongwhane Lee1, Deok Hee Lee2, Dae Chul Suh2, Hyuk Sung Kwon3, Da-Eun Jeong4, Joong-Goo Kim5, Ji-Sung Lee6, Jong S Kim7, Dong-Wha Kang7, Sang-Beom Jeon7, Eun-Jae Lee7, Kyung Chul Noh7, Sun U Kwon8. 1. Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea. 2. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 3. Department of Neurology, Hanyang University College of Medicine, Seoul, South Korea. 4. Department of Neurology, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, South Korea. 5. Department of Neurology, Jeju National University Hospital, Jeju, South Korea. 6. Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea. 7. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. 8. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. sunkwon7@gmail.com.
Abstract
BACKGROUND AND PURPOSE: This study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic stroke patients with active cancer. METHODS: We retrospectively reviewed 253 patients who underwent IAT within 24 h after stroke onset between January 2012 and August 2017. We classified the patients into active cancer (n = 26) and control groups (n = 227) and compared clinical data. Primary outcome was a modified Rankin scale score at 3 months with ordinal logistic regression (shift analysis). RESULTS: Initial National Institutes of Health Stroke Scale (NIHSS) and rate of successful recanalisation did not differ between groups, but the active cancer group showed poor outcomes at 3 months on shift analysis (P = 0.001). The independent predictors of poor prognosis were age [adjusted common odds ratio (aOR) 1.03, 95% confidence interval (CI) 1.01-1.05], baseline NIHSS (aOR 1.14, 95% CI 1.09-1.19), baseline C-reactive protein level (aOR 1.14, 95% CI 1.03-1.25), any cerebral haemorrhage (aOR 1.92, 95% CI 1.21-3.06), and active cancer (aOR 2.35, 95% CI 1.05-5.25). Mortality at 90 days was 30.8% in the cancer group and 8.8% in the control group (P = 0.003). CONCLUSIONS: Although baseline characteristics and recanalisation rate after IAT up to 24 h after stroke onset were similar between acute ischaemic stroke patients with active cancer and without any cancer, stroke-related death and short-term outcome were significantly poorer in patients with active cancer than the controls. Post-procedural haemorrhage and active cancer itself were independent predictors of a decrease in functional independence at 3 months.
BACKGROUND AND PURPOSE: This study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic strokepatients with active cancer. METHODS: We retrospectively reviewed 253 patients who underwent IAT within 24 h after stroke onset between January 2012 and August 2017. We classified the patients into active cancer (n = 26) and control groups (n = 227) and compared clinical data. Primary outcome was a modified Rankin scale score at 3 months with ordinal logistic regression (shift analysis). RESULTS: Initial National Institutes of Health Stroke Scale (NIHSS) and rate of successful recanalisation did not differ between groups, but the active cancer group showed poor outcomes at 3 months on shift analysis (P = 0.001). The independent predictors of poor prognosis were age [adjusted common odds ratio (aOR) 1.03, 95% confidence interval (CI) 1.01-1.05], baseline NIHSS (aOR 1.14, 95% CI 1.09-1.19), baseline C-reactive protein level (aOR 1.14, 95% CI 1.03-1.25), any cerebral haemorrhage (aOR 1.92, 95% CI 1.21-3.06), and active cancer (aOR 2.35, 95% CI 1.05-5.25). Mortality at 90 days was 30.8% in the cancer group and 8.8% in the control group (P = 0.003). CONCLUSIONS: Although baseline characteristics and recanalisation rate after IAT up to 24 h after stroke onset were similar between acute ischaemic strokepatients with active cancer and without any cancer, stroke-related death and short-term outcome were significantly poorer in patients with active cancer than the controls. Post-procedural haemorrhage and active cancer itself were independent predictors of a decrease in functional independence at 3 months.
Entities:
Keywords:
Cancer and stroke; Endovascular recanalisation; Ischaemic stroke; Thrombectomy
Authors: Ignacio Casado-Naranjo; Maria Luisa Calle; Alfonso Falcón; Ana Serrano; Juan Carlos Portilla; José María Ramírez-Moreno Journal: J Neurol Neurosurg Psychiatry Date: 2010-11-08 Impact factor: 10.154
Authors: Shihab Masrur; Abdul R Abdullah; Eric E Smith; Renzo Hidalgo; Ahmed El-Ghandour; Guy Rordorf; Lee H Schwamm Journal: J Stroke Cerebrovasc Dis Date: 2010-07-03 Impact factor: 2.136
Authors: M Fiorelli; S Bastianello; R von Kummer; G J del Zoppo; V Larrue; E Lesaffre; A P Ringleb; S Lorenzano; C Manelfe; L Bozzao Journal: Stroke Date: 1999-11 Impact factor: 7.914