1412P_PR - Ischemic stroke as cancer predecessor and associated predictors

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cancer Aetiology, Epidemiology, Prevention
Presenter Jacobo Rogado
Citation Annals of Oncology (2017) 28 (suppl_5): v605-v649. 10.1093/annonc/mdx440
Authors J. Rogado1, V. Pacheco1, R. Mondejar1, S. Quintas2, P. Gullón3, J. Dotor2, M.D. Fenor de la Maza1, B. Obispo1, G. Reig-Roselló2, T. Pascual1, A.I. Ballesteros Garcia1, O. Donnay1, J.M. Sánchez-Torres1, R. López Ruiz2, J. Vivancos2, R. Colomer Bosch1
  • 1Medical Oncology, Hospital Universitario de La Princesa, 28006 - Madrid/ES
  • 2Neurology, Hospital Universitario de La Princesa, 28006 - Madrid/ES
  • 3Escuela Nacional De Sanidad, Instituto de salud Carlos III, Madrid/ES

Abstract

Background

Ischemic Stroke (IS) has been related to cancer in postmortem studies of oncologic patients and as being the first expression of an occult neoplasm, probably because of hypercoagulability attributed to cancer. The aim of the study was to detect an association between cancer and IS, and possible predictors of cancer among these patients.

Methods

Nine hundred seventeen patients with IS were retrospectively collected from January 2012 to December 2014 in our hospital with a following time of 18 months. Patients with active or previous cancer within 5 years, TIA or cerebral hemorrhage, inability to follow-up or absence of complementary study of IS were excluded. Detection of cancer divided the patients in two cohorts. Demographical, clinical, analytical and prognostic characteristics were collected and subsequently compared between patients with development of tumor (Cancer Patients -CP-) and those free of malignancy (No Cancer Patients -NCP-).

Results

Cancer were detected in 29 out of 381 IS patients who finally met criteria (7.61%), instead of the 17 patients expected, according to cancer incidence in general population. The mean time from IS onset to cancer diagnosis was 6 months, with 44.83% of the diagnoses within the first 6 months after IS. The most frequent locations were colon (24%), lung and prostate (14%). 62% of CP presented metastatic or locally advanced desease. Older age (p = 0.003), previous cancer >5 years (p = 0.042), higher fibrinogen (p = 0.019) and lower hemoglobin (Hb) values (p = 0.004) were predictors of occult neoplasm. No differences were found in other analytical parameters, thromboembolic risk factors, nor with the etiology and clinical manifestations of the stroke.

Conclusions

In our study IS is associated with cancer, based on the fact that the incidence is almost twice that of general population. The diagnosis of cancer was mainly in advanced stages and within 6 months from IS. It suggests the presence of cancer at the diagnosis of IS due to prothrombotic effect of cancer, without being atributted, therefore, to a greater medical control than general population. Older age, previous cancer, fibrinogen and Hb values were related to the diagnosis of cancer after IS, being potential predictors in this group of patients.

Clinical trial identification

Legal entity responsible for the study

Servicio de Oncología Médica, Hospital Universitario de La Princesa. Instituto de Investigación Sanitaria Princesa

Funding

None

Disclosure

All authors have declared no conflicts of interest.