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
Kyohei Fujita, Yohei Sato, Ryoichi Hanazawa, Hirotaka Sagawa, Mariko Ishikawa, Shoko Fujii, Jiro Aoyama, Sakyo Hirai, Masataka Yoshimura, Yoshikazu Yoshino, Yoshihisa Kawano, Keigo Shigeta, Naoki Taira, Jun Karakama, Tadahiro Ishiwada, Motoshige Yamashina, Akihiko Hirakawa, Kazutaka Sumita- General Medicine
Aim
Assessing 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.
Methods
Of 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.
Results
Of 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.
Conclusions
The 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; ••: ••–••.