Predictors of unknown cancer in patients with ischemic stroke

Quintas, Sonia; Rogado, Jacobo; Gullón, Pedro; Pacheco-Barcía, Vilma; García‐Soto, Julio Dotor; Reig-Roselló, G.; Mondéjar, Rebeca; Colomer, Ramón; Vivancos, José

doi:10.1007/s11060-017-2741-0

Cited by 28 publications

(24 citation statements)

References 30 publications

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“…3 In the year before cancer is diagnosed when cancer is occult, the risk of stroke is almost twice that in the background population without occult cancer. [4][5][6][7][8] Comparative studies on prevalence of occult cancer in comparable background populations are missing. A prerequisite for implementation of cancer screening would be that prevalence of occult cancers in the stroke population is markedly higher than in the background population.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk of occult cancer in stroke

2019

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Objectives: Cancer is associated with higher risk of stroke. Whether this translates into higher risk of cancer in stroke of an extent calling for cancer screening in stroke is unclear. We investigated prevalence and risk of occult cancer in stroke compared to the background population without history of stroke. Materials and methods: All patients >40 years of age with incident stroke in Denmark 2003-2015 were identified through the Danish Stroke Registry (n = 85 893) and matched 1:10 on age and sex to the Danish background population without history of stroke (n = 858 740). Linking data to the Danish Cancer Registry, we determined prevalence of occult cancer in stroke defined as the event of previously unknown cancer during a 1-year follow-up in the stroke and in the background population. Cox regression models were used to study risk in comparison to the background population. Results: Prevalence (per 1000) of occult cancer in the stroke/background cohorts was 25.0/15.8 in women and 29.8/20.4 in men. Prevalence was dependent on age and sex. Highest among stroke patients aged 70-80 years (35.6 in women, 42.4 in men); lowest in patients aged 40-50 years (8.3 in women, 6.8 in men). Stroke was associated with an overall 54% higher risk of occult cancer but risk increased significantly with smoking, hazard ratio (HR) 1.47, age HR 1.27 per 10 years, male sex HR 1.25, and diabetes HR 1.25. Conclusions:Prevalence and risk of occult cancer in stroke is considerable and calls for attention when designing the stroke investigation program. K E Y W O R D Scancer, prevalence, risk, stroke

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Section: Introductionmentioning

confidence: 99%

“…Knowledge on the prevalence of occult cancer in stroke is, however, sparse and relies on a few smaller studies reporting prevalence from 0.4% to 4.75%. [4][5][6][7][8] Comparative studies on prevalence of occult cancer in comparable background populations are missing.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk of occult cancer in stroke

2019

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“…It is very important to explore which microenvironment as metastatic core for BM in NSCLC due to its significant mortality. It' s a remarkable that the rate of cancer incidence is higher among ischemic stroke patients than the general population 9,13,21,22,25) , and cancer itself may increase a risk of CI occurrence 10,11,16,30) . Once CI occurs in patients with cancer, neurological outcomes significantly worsen, and prognosis tends to be poor in addition to stroke-associated morbidity/mortality 5,15,19) .…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic criteria of CI refer to Updated Criteria for Population-Based Stroke and Transient Ischemic Attack Incidence Studies for the 21st Century8), which points out that CI can be diagnosed regardless of the duration of nervous symptoms/ signs when there are neuroimaging findings of responsible ischemic lesion. However, when no evidence of imaging evidence of responsible lesion can be obtained, the duration of symptoms and signs exceeding 24h is still the time limit for diagnosis of ischemic stroke 8) .…”

Section: The Diagnosis Of Cerebral Infarctionmentioning

confidence: 99%

Role of Cancer Emboli as a Metastatic Core on the Growth of Brain Metastasis in Patients with Non-Small Cell Lung Cancer

Kim

Gyu-Seo

Hoon-Gi

et al. 2020

J Neurointensive Care

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Brain metastasis (BM) was a common complication of patient with non-small cell lung cancer (NSCLC) and associated with a poor prognosis. The study was to evaluate the effect of cerebral infarction (CI) which was originated from cancer emboli on the risk of BM in NSCLC for preventive therapy strategy. Methods Three hundred seven patients with newly diagnosed NSCLC in our institute from July 2013 to July 2018 were retrospectively analyzed. The diagnostic criteria of CI refereed to Updated Criteria for Population-Based Stroke and Transient Ischemic Attack Incidence Studies for the 21st Century. Depending on magnetic resonance imaging (MRI), the patients were divided into the BM group and control group (without BM). Then, the prevalence of CI and baseline clinicopathological parameters were evaluated and compared between the two groups. Results Of the 307 patients, 204 patients (66.4%) had CI and 52 patients (16.9%) had BM. Especially, the prevalence of CI in the NSCLC patients with BM was 84.6%, which was significantly higher than that of 62.7% in the NSCLC patients without BM (p = 0.002). Following univariate logistic regression analysis and the multivariate model, the results demonstrated that CI was a significant independent risk factor for BM in NSCLC (odds rate, 3.303; 95% confidence interval, 1.437-7.593; p = 0.005). What's more, CI contributed to a worse prognosis in NSCLC patients with BM. Dynamical trace confirmed CI could promote BM in NSCLC patient. Conclusions CI could be associated with a metastatic tropism to the brain and then with an increased risk of BM in NSCLC patient. Therefore, targeted intervention of the metastatic core of CI could offer promising approach for the prevention, prognostic evaluation, and therapy of BM in NSCLC patients for better clinical outcome.

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“…In one large study, a one‐year survival of only 12% was seen . Hypercoagulability is also possible on the arterial side with data suggesting as much as a risk of 7% of a cancer diagnosis after an ischemic stroke presentation . Strokes caused by cancer are known to be associated with an embolic patterns in multiple territories, more often cryptogenic and with elevated D‐dimer .…”

Section: Discussionmentioning

confidence: 99%