Diagnosis of Incident Cancer After Cryptogenic Stroke: An Exploratory Analysis of the ARCADIA Randomized Trial.

IF 7.7 1区医学 Q1 CLINICAL NEUROLOGY

Neurology Pub Date : 2024-11-26 Epub Date: 2024-10-31 DOI:10.1212/WNL.0000000000210027

Babak B Navi, Cenai Zhang, Benjamin R Miller, Anokhi Pawar, Mary Cushman, Scott E Kasner, David Tirschwell, W T Longstreth, Richard Kronmal, Jordan Elm, Richard M Zweifler, Joseph Tarsia, Joseph P Broderick, David J Gladstone, Morin Beyeler, Hooman Kamel, Mitchell S V Elkind, Christopher Streib

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引用次数: 0

Abstract

Objectives: The objective of this study was to estimate the incidence, timing, and type of new cancer diagnosis among patients with cryptogenic stroke.

Methods: We used data from the ARCADIA trial, which enrolled patients with cryptogenic stroke and atrial cardiopathy. Participants were prospectively followed, and serious adverse events were assessed every 3 months or sooner if investigators were alerted between visits to an event. Kaplan-Meier statistics were used to estimate the cumulative incidence of a cancer diagnosis within the first year after randomization.

Results: Among 878 participants without baseline history of cancer, 13 (1.5%) were diagnosed with incident cancer in the year after randomization, comprising 12 solid cancers (3 prostate, 2 breast, 2 gastrointestinal, and 5 other primary sites) and 1 hematologic cancer (non-Hodgkin lymphoma). The cumulative incidences of a cancer diagnosis were 0% at 3 months, 0.6% (95% CI 0.2%-1.5%) at 6 months, and 2.0% (95 CI 1.1%-3.4%) at 1 year. The median time from index stroke to cancer diagnosis was 261 days (interquartile range 183-358).

Discussion: In a multicenter cryptogenic stroke cohort with prospective follow-up, the 1-year cumulative incidence of a cancer diagnosis was 2%. This rate may be an underestimation because of the clinical trial population and exclusion of cancers diagnosed immediately after stroke.

Trial registration information: ClinicalTrials.gov Identifier: NCT03192215. Registered June 20, 2017. First patient enrolled February 1, 2018.

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隐源性卒中后的癌症诊断：ARCADIA 随机试验的探索性分析。

研究目的本研究旨在估算隐源性中风患者新诊断癌症的发生率、时间和类型：我们使用了 ARCADIA 试验的数据，该试验招募了隐源性中风和心房性心脏病患者。我们对参与者进行了前瞻性随访，每 3 个月对严重不良事件进行一次评估，如果调查人员在两次随访之间接到事件警报，则提前进行评估。采用 Kaplan-Meier 统计法估算随机化后第一年内癌症诊断的累积发生率：在基线无癌症病史的 878 名参与者中，有 13 人（1.5%）在随机化后一年内被诊断为癌症，其中包括 12 例实体癌（3 例前列腺癌、2 例乳腺癌、2 例胃肠道癌症和 5 例其他原发部位癌症）和 1 例血液系统癌症（非霍奇金淋巴瘤）。癌症诊断的累计发生率为：3 个月时 0%，6 个月时 0.6%（95% CI 0.2%-1.5%），1 年时 2.0%（95% CI 1.1%-3.4%）。从指数中风到癌症确诊的中位时间为 261 天（四分位间范围 183-358）：讨论：在具有前瞻性随访的多中心隐源性卒中队列中，癌症诊断的 1 年累积发生率为 2%。讨论：在多中心隐匿性中风队列的前瞻性随访中，1 年的累积癌症发病率为 2%，由于临床试验人群以及排除了中风后立即确诊的癌症患者，该发病率可能被低估了：试验注册信息：ClinicalTrials.gov Identifier：NCT03192215。2017年6月20日注册。2018年2月1日首例患者入组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology 医学-临床神经学

CiteScore

12.20

自引率

4.00%

发文量

1973

审稿时长

2-3 weeks

期刊介绍： Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology. As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content. Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.