141P - Ischemic Stroke and Cancer Correlation: A Stroke Unit Experience

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cancer in Adolescents
Translational Research
Presenter Mariana Rodrigues
Citation Annals of Oncology (2017) 28 (suppl_5): v22-v42. 10.1093/annonc/mdx363
Authors M. Rodrigues1, R. Costa2, S. Brito2, A. Pissarra1, A. Lourenço3, F. Grenho3, L. Campos3
  • 1Medical Oncology, Hospital São Francisco Xavier, 1400-065 - Lisbon/PT
  • 2Internal Medicine, Hospital São Francisco Xavier, 1400-065 - Lisbon/PT
  • 3Stroke Unit/internal Medicine, Hospital São Francisco Xavier, 1400-065 - Lisbon/PT

Abstract

Background

Cancer (Cr) and ischemic stroke (IS) are common causes of death in high-income regions. Cr patients present a higher probability of developing thromboembolic events, particularly IS. Measurable objective parameters may be helpful stating a neoplastic etiology: High D-dimer (DD) levels; C-reactive protein (CRP); Neutrophil–lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) express the severity of inflammation relating it to etiology and prognosis. Single centre retrospective study analyses patients with IS and active solid Cr (NG) with purpose of identifying clinical, laboratorial and imagological features that differentiate this from a control group (CG) without Cr.

Methods

Patients with IS admitted in a Stroke Unit from 01/2009 to 12/2014. Active cancer identified in clinical process. Transient ischemia, haemorrhagic strokes and other diagnosis excluded. For CG an age and gender matching patient was chosen. Clinical, analytical and imagological features were compared between groups. Statistical analysis using the SPSS Statistics V22.

Results

Out of 603 consecutive patients with IS, 48 (7.9%) had active solid Cr, 16 diagnosed during diagnostic work-up for IS, 24 before and 8 in the year after. Male predominance: 30 patients (62,5%). 14: metastatic disease. Most frequent Cr diagnosed were prostate and bladder (12,5% each); colon(10%) and lung(8,3%). Cardioembolism was the main subgroup in both (26 NG; 24 CG). Imagiologic pattern was similar in both groups. NG had increased laboratorial values compared to CG: LDH 602 vs 501 U/L (p 0,04); CPR 3,2 vs 1,8 mg/dL (p 0,11) and DD 0,85 vs 0,7ug/mL (p 0,28). Average NLR and PLR: 5,4 and 161,6 NG vs 2,34 and 104,1 CG (p 

Conclusions

Although Cr is a rare cause of stroke, it should not be devalued. There are several clinical, laboratory and imagiological signs of underlying neoplastic disease that should be considered, since they may promote an earlier diagnosis and approach to this pathology. Future prospective studies should be started in order to validate some of this parameters as indicators of subjacent neoplastic disease.

Clinical trial identification

Legal entity responsible for the study

Mariana Rodrigues

Funding

None

Disclosure

All authors have declared no conflicts of interest.