{"title":"Ischemic stroke in patients with unresectable pancreatic and gastric cancer.","authors":"Kohei Oka, Naoto Iwai, Tomoyuki Ohara, Akiko Watanabe, Kengo Okabe, Tomoya Ohara, Hiroaki Sakai, Shinya Okishio, Mariko Kubota-Kajiwara, Toshifumi Tsuji, Keizo Kagawa, Junichi Sakagami, Toshifumi Doi, Osamu Dohi, Kanji Yamaguchi, Michihisa Moriguchi, Takeshi Ishikawa, Tomohisa Takagi, Hideyuki Konishi, Yoshito Itoh","doi":"10.1007/s10147-025-02731-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Thromboembolism, including ischemic stroke and venous thromboembolism (VTE), is a critical complication in patients with advanced cancer. Pancreatic cancer and gastric cancer are classified as \"very high risk\" cancers based on the Khorana score, a risk model for VTE. However, the cumulative incidence of ischemic stroke in patients with unresectable pancreatic and gastric cancers has not been elucidated. This study evaluated the incidence and mortality of ischemic stroke in patients with unresectable pancreatic and gastric cancer.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included patients diagnosed with unresectable pancreatic or gastric cancer between January 2009 and December 2021.</p><p><strong>Results: </strong>Among 276 patients, ischemic stroke occurred in 18 patients. All 18 patients were categorized into cancer-associated stroke (CAS), including cancer-related coagulopathy, by a board certified fellow. The 1-year cumulative incidence rates were 10.2% in patients with unresectable pancreatic cancer and 5.8% in patients with unresectable gastric cancer (P = 0.22). The median survival time after stroke was significantly shorter for patients with unresectable pancreatic cancer than for patients with unresectable gastric cancer (41 days vs 116 days, P < 0.05). In contrast, no significant difference was observed in overall survival (OS) between patients with and without ischemic stroke (244 days vs 221 days, P = 0.66).</p><p><strong>Conclusion: </strong>This study's findings indicated that CAS accounts for most ischemic stroke in patients with unresectable pancreatic and gastric cancers. Moreover, the prognosis after ischemic stroke was significantly worse in patients with unresectable pancreatic cancer. However, ischemic stroke itself may not influence OS in patients with unresectable pancreatic or gastric cancer.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02731-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Thromboembolism, including ischemic stroke and venous thromboembolism (VTE), is a critical complication in patients with advanced cancer. Pancreatic cancer and gastric cancer are classified as "very high risk" cancers based on the Khorana score, a risk model for VTE. However, the cumulative incidence of ischemic stroke in patients with unresectable pancreatic and gastric cancers has not been elucidated. This study evaluated the incidence and mortality of ischemic stroke in patients with unresectable pancreatic and gastric cancer.
Methods: This retrospective, single-center cohort study included patients diagnosed with unresectable pancreatic or gastric cancer between January 2009 and December 2021.
Results: Among 276 patients, ischemic stroke occurred in 18 patients. All 18 patients were categorized into cancer-associated stroke (CAS), including cancer-related coagulopathy, by a board certified fellow. The 1-year cumulative incidence rates were 10.2% in patients with unresectable pancreatic cancer and 5.8% in patients with unresectable gastric cancer (P = 0.22). The median survival time after stroke was significantly shorter for patients with unresectable pancreatic cancer than for patients with unresectable gastric cancer (41 days vs 116 days, P < 0.05). In contrast, no significant difference was observed in overall survival (OS) between patients with and without ischemic stroke (244 days vs 221 days, P = 0.66).
Conclusion: This study's findings indicated that CAS accounts for most ischemic stroke in patients with unresectable pancreatic and gastric cancers. Moreover, the prognosis after ischemic stroke was significantly worse in patients with unresectable pancreatic cancer. However, ischemic stroke itself may not influence OS in patients with unresectable pancreatic or gastric cancer.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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