Impact of cancer history on long‐term outcome after elective neuro‐endovascular treatment in patients aged 80 years or older: A retrospective multicenter observational study

Author:

Fujita Kyohei1,Sato Yohei2,Hanazawa Ryoichi3,Sagawa Hirotaka1,Ishikawa Mariko1,Fujii Shoko14,Aoyama Jiro1,Hirai Sakyo1,Yoshimura Masataka5,Yoshino Yoshikazu6,Kawano Yoshihisa7,Shigeta Keigo8,Taira Naoki9,Karakama Jun4,Ishiwada Tadahiro10,Yamashina Motoshige11,Hirakawa Akihiko3,Sumita Kazutaka1ORCID

Affiliation:

1. Department of Endovascular Surgery Tokyo Medical and Dental University Tokyo Japan

2. Department of Neurosurgery Japanese Red Cross Musashino Hospital Tokyo Japan

3. Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

4. Department of Neurosurgery Ome Municipal General Hospital Tokyo Japan

5. Department of Neurosurgery Tsuchiura Kyodo General Hospital Ibaraki Japan

6. Department of Neurosurgery Jichi Medical University Saitama Medical Center Saitama Japan

7. Department of Neurosurgery JA Toride Medical Center Ibaraki Japan

8. Department of Neurosurgery National Hospital Organization Disaster Medical Center Tokyo Japan

9. Department of Neurosurgery Shuuwa General Hospital Saitama Japan

10. Department of Neurosurgery Shioda Memorial Hospital Chiba Japan

11. Department of Neurosurgery Soka Municipal Hospital Saitama Japan

Abstract

AimAssessing the indication for elective neuro‐endovascular treatment (EVT) in older patients requires consideration of the impact of systemic comorbidities on their overall reduced life expectancy. The objective of this study was to determine the long‐term outcomes of elective neuro‐EVT in patients aged ≥80 years, and to investigate the impact of pre‐existing cancer on their long‐term outcomes.MethodsOf the patients enrolled in multicenter observational registry, those aged ≥80 years undergoing elective neuro‐EVT between 2011 and 2020 were enrolled. A history of cancer was defined as a pre‐existing solid or hematologic malignancy at the time of EVT. The primary outcome was time to death from elective neuro‐EVT.ResultsOf the 6183 neuro‐EVT cases implemented at 10 stroke centers, a total of 289 patients (median age, 82 years [interquartile range 81–84 years]) were analyzed. A total of 58 (20.1%) patients had a history of cancer. A total of 78 patients (27.0%) died during follow up. The 5‐year survival rate of enrolled patients was 64.6%. Compared with patients without a history of cancer, those with a history of cancer showed significantly worse survival (log‐rank test, P = 0.001). Multivariate Cox proportional hazards analysis showed history of cancer was an independent predictor of time to death from elective neuro‐EVT (HR 1.74, 95% CI 1.01–3.00, P = 0.047). Cancer was the leading cause of death, accounting for 25.6% of all deaths.ConclusionsThe present study showed that history of cancer has a significant impact on time to death from elective neuro‐EVT in patients aged ≥80 years. Geriatr Gerontol Int 2023; ••: ••–••.

Publisher

Wiley

Subject

General Medicine

Reference24 articles.

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2. Japanese Surveillance of Neuroendovascular Therapy in JR-NET - Part II. Japanese Registry of NeuroEndovascular Treatment 3. Main Report

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4. VincentGK VelkoffVA.The next four decades. The older population in the United States: 2010–50. Population estimates and projections Available from:https://www.census.gov/content/dam/Census/library/publications/2010/demo/p25-1138.pdfaccessed 21 October 2023.

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