Short-Term Outcome of Ischemic Stroke Patients With Systemic Malignancy

Joonsang Yoo, Hyo Suk Nam, Young Dae Kim, Hye Sun Lee, Jihoe Heo

Research output: Contribution to journalArticle

Abstract

Background and Purpose- Recent guidelines have suggested the potential benefit of intravenous thrombolysis in stroke patients with systemic malignancy who have a reasonable life expectancy of >6 months. However, it is difficult to determine which patients with cancer will have a life expectancy of >6 months. Therefore, we identified the factors associated with 6-month mortality in patients with acute ischemic stroke and systemic malignancy. Methods- Consecutive stroke patients with systemic malignancy were retrospectively analyzed. We classified the patients into 3 groups: the nonactive cancer, active nonmetastatic cancer, and metastatic cancer groups. We compared the baseline characteristics and 6-month survival rates. Results- Of the 468 ischemic stroke patients with systemic malignancy during an 8-year period, 223 patients had nonactive cancer, 105 patients had active nonmetastatic cancer, and 140 patients had metastasis. During the 6-month follow-up, 122 patients (26.1%) died (nonactive cancer group [7.2%, 16/223], active nonmetastatic cancer group [11.4%, 12/105], and metastatic cancer group [67.1%, 94/140]). Multivariate Cox regression analysis revealed that the presence of metastasis (hazard ratio, 4.527; 95% CI, 2.175-9.422) was independently associated with 6-month mortality. However, the active nonmetastatic cancer group exhibited similar 6-month mortality to the nonactive cancer group (hazard ratio, 0.711; 95% CI, 0.282-1.795). Gastric/esophageal cancer and pancreatic cancer were also independently associated with 6-month mortality (hazard ratio, 2.068 and 2.389, respectively). Conclusions- In stroke patients with active cancer, the presence of metastasis and the cancer type were crucial factors associated with 6-month mortality.

Original languageEnglish
Pages (from-to)507-511
Number of pages5
JournalStroke
Volume50
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Stroke
Neoplasms
Mortality
Neoplasm Metastasis
Life Expectancy
Esophageal Neoplasms
Pancreatic Neoplasms
Stomach Neoplasms
Survival Rate
Regression Analysis
Guidelines

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Yoo, Joonsang ; Nam, Hyo Suk ; Kim, Young Dae ; Lee, Hye Sun ; Heo, Jihoe. / Short-Term Outcome of Ischemic Stroke Patients With Systemic Malignancy. In: Stroke. 2019 ; Vol. 50, No. 2. pp. 507-511.
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abstract = "Background and Purpose- Recent guidelines have suggested the potential benefit of intravenous thrombolysis in stroke patients with systemic malignancy who have a reasonable life expectancy of >6 months. However, it is difficult to determine which patients with cancer will have a life expectancy of >6 months. Therefore, we identified the factors associated with 6-month mortality in patients with acute ischemic stroke and systemic malignancy. Methods- Consecutive stroke patients with systemic malignancy were retrospectively analyzed. We classified the patients into 3 groups: the nonactive cancer, active nonmetastatic cancer, and metastatic cancer groups. We compared the baseline characteristics and 6-month survival rates. Results- Of the 468 ischemic stroke patients with systemic malignancy during an 8-year period, 223 patients had nonactive cancer, 105 patients had active nonmetastatic cancer, and 140 patients had metastasis. During the 6-month follow-up, 122 patients (26.1{\%}) died (nonactive cancer group [7.2{\%}, 16/223], active nonmetastatic cancer group [11.4{\%}, 12/105], and metastatic cancer group [67.1{\%}, 94/140]). Multivariate Cox regression analysis revealed that the presence of metastasis (hazard ratio, 4.527; 95{\%} CI, 2.175-9.422) was independently associated with 6-month mortality. However, the active nonmetastatic cancer group exhibited similar 6-month mortality to the nonactive cancer group (hazard ratio, 0.711; 95{\%} CI, 0.282-1.795). Gastric/esophageal cancer and pancreatic cancer were also independently associated with 6-month mortality (hazard ratio, 2.068 and 2.389, respectively). Conclusions- In stroke patients with active cancer, the presence of metastasis and the cancer type were crucial factors associated with 6-month mortality.",
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Short-Term Outcome of Ischemic Stroke Patients With Systemic Malignancy. / Yoo, Joonsang; Nam, Hyo Suk; Kim, Young Dae; Lee, Hye Sun; Heo, Jihoe.

In: Stroke, Vol. 50, No. 2, 01.02.2019, p. 507-511.

Research output: Contribution to journalArticle

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