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.

Autor: Fujita K; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Sato Y; Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan., Hanazawa R; Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Sagawa H; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Ishikawa M; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Fujii S; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.; Department of Neurosurgery, Ome Municipal General Hospital, Tokyo, Japan., Aoyama J; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Hirai S; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Yoshimura M; Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Yoshino Y; Department of Neurosurgery, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kawano Y; Department of Neurosurgery, JA Toride Medical Center, Ibaraki, Japan., Shigeta K; Department of Neurosurgery, National Hospital Organization Disaster Medical Center, Tokyo, Japan., Taira N; Department of Neurosurgery, Shuuwa General Hospital, Saitama, Japan., Karakama J; Department of Neurosurgery, Ome Municipal General Hospital, Tokyo, Japan., Ishiwada T; Department of Neurosurgery, Shioda Memorial Hospital, Chiba, Japan., Yamashina M; Department of Neurosurgery, Soka Municipal Hospital, Saitama, Japan., Hirakawa A; Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Sumita K; Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Geriatrics & gerontology international [Geriatr Gerontol Int] 2024 Feb; Vol. 24 (2), pp. 211-217. Date of Electronic Publication: 2023 Dec 21.
DOI: 10.1111/ggi.14784
Abstrakt: 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 2024; 24: 211-217.
(© 2023 Japan Geriatrics Society.)
Databáze: MEDLINE
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