Abstract
Objectives Some studies indicate a poor overall survival in malignancy-associate stroke due to prothrombotic states, however the functional outcomes for people with active cancer following endovascular thrombectomy (EVT) are unclear.1
Methods We retrospectively analyzed all EVT cases at Princess Alexandra Hospital from January 2021 to December 2022 in patients with active malignancy. We examined for modified Rankin score (mRS), National Institute of Health Stroke Scale (NIHSS) at presentation and discharge, and mRS at both 3 and 12 months. Malignancy type was grouped according to organ system.
Results Two hundred eighty-four EVT cases were performed with four patients undergoing thrombectomy twice. Sixteen patients had active malignancy (male, n=10) with an average age of 74.2 years (range: 56–91 years). The mean NIHSS on presentation was 17 (range: 7–27). Pre-stroke mRS was 0 in 7 patients (43.75%), 1 in 3 patients (18.75%), and 2 in 6 patients (37.5%). Four of 16 patients returned to pre-stroke mRS (25%), but no individual returned to an mRS of 0. Four patients died within 3 months from stroke (25%) with one each having bladder, endometrial, metastatic melanoma and metastatic squamous cell carcinoma. Two additional patients died within 12 months from progressive malignancy.
Conclusions Our study shows that patients with active malignancy can have a good functional outcome from EVT, although a significant minority of patients died within 12 months from stroke. Overall, the small number of patients with cancer do not allow for better stratification or prognostication in stroke caused by large vessel occlusion.
Reference
Krishna C Joshi, et al. Endovascular thrombectomy for acute ischemic stroke in patients with cancer: a propensity-matched analysis, Dec 2021| Journal of NeuroInterventional Surgery (bmj.com)
