Does malignancy status effect outcomes in patients with large vessel occlusion stroke and cancer that underwent endovascular thrombectomy?

Abstract

AbstractBackgroundCancer is associated with an increased risk of acute ischemic stroke (AIS) including large vessel occlusions (LVO). Whether cancer status affects outcomes in patients with LVO that undergo endovascular thrombectomy (EVT) remains unknown.Methods and ResultsAll consecutive patients undergoing EVT for LVO were recruited into a prospective ongoing multi-center database and the data was retrospectively analyzed. Patients with active cancer were compared to patients with cancer in remission. Association of cancer status with 90-day functional outcome and mortality were calculated in multivariable analyses. We identified 154 patients with cancer and LVO that underwent EVT (mean age 74±11, 43% men, median NIHSS 15). Of the included patients, 70 (46%) had a remote history of cancer or cancer in remission and 84 (54%) had active disease. Outcome data at 90 days post-stroke was available for 138 patients (90%) and was classified as favorable in 53 (38%). Patients with active cancer were younger and more often smoked but did not significantly differ from those without malignancy in other risk factors, stroke severity, stroke subtype or procedural variables. Favorable outcome rates among patients with active cancer did not significantly differ compared to those seen in patients without active cancer but mortality rates were significantly higher among patients with active cancer on univariate and multivariable analyses.ConclusionsOur study suggests that EVT is safe and efficacious in patients with history of malignancy as well as in those with active cancer at the time of stroke onset although mortality rates are higher among patients with active cancer.Clinical PerspectivesWhat is new?The results of the current study suggest that EVT is safe and efficacious in patients with history of malignancy as well as in those with active cancer at the time of stroke onset although mortality rates are significantly higher and favorable outcome rates tend to be lower among patients with active cancer.What are the clinical implications?The results imply that all cancer patients with LVO stroke should be considered for EVT regardless of cancer status.