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.
cancer
elder
endovascular treatment
mortality
Journal
Geriatrics & gerontology international
ISSN: 1447-0594
Titre abrégé: Geriatr Gerontol Int
Pays: Japan
ID NLM: 101135738
Informations de publication
Date de publication:
21 Dec 2023
21 Dec 2023
Historique:
revised:
27
10
2023
received:
27
06
2023
accepted:
05
12
2023
medline:
21
12
2023
pubmed:
21
12
2023
entrez:
21
12
2023
Statut:
aheadofprint
Résumé
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. 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. 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. 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; ••: ••-••.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 Japan Geriatrics Society.
Références
Sakai N, Yoshimura S, Taki W et al. Recent trends in neuroendovascular therapy in Japan: analysis of a nationwide survey - Japanese registry of Neuroendovascular therapy (JR-NET) 1 and 2. Neurol Medico-Chirurgica (Tokyo) 2014; 54: 1-8.
Sakai N, Uchida K, Iihara K et al. Japanese surveillance of neuroendovascular therapy in JR-NET - part II. Japanese registry of NeuroEndovascular treatment 3. Main Report Neurol Medico-Chirurgica (Tokyo) 2019; 15: 106-115.
Population projections. EU25 population rises until 2025, then falls; 2005, Available from: https://ec.europa.eu/commission/presscorner/api/files/document/print/en/stat_05_48/STAT_05_48_EN.pdf 2004-2050. accessed 31 March 2023.
Vincent GK, Velkoff VA. The next four decades. The older population in the United States: 2010-50. Population estimates and projections, Available from: https://www.census.gov/content/dam/Census/library/publications/2010/demo/p25-1138.pdf accessed 21 October 2023.
Ministry of internal affairs and communications. Population estimates, 2021. Available from: https://www.stat.go.jp/data/jinsui/2021np/pdf/2021np.pdf [accessed 31 March 2023].
National Institute of Population and Social Security Research. Population projections for Japan, 2017. Available from: https://www.ipss.go.jp/pp-zenkoku/j/zenkoku2017/pp29_ReportALL.pdf [accessed 31 March 2023].
Caffes N, Wenger N, Cannarsa G et al. Unruptured cerebral aneurysms in elderly patients: key challenges and management. Ann Med 2021; 53: 1839-1849.
Laconi E, Marongiu F, DeGregori J. Cancer as a disease of old age: changing mutational and microenvironmental landscapes. Br J Cancer 2020; 122: 943-952.
Ishiwada T, Fujita K, Hirai S et al. Influence of bilateral cerebellar infarction on functional outcome after endovascular treatment for basilar artery occlusion. World Neurosurg 2023; 171: e506-e515.
Khorana AA, Noble S, Lee AYY et al. Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH. J Thromb Haemost 2018; 16: 1891-1894.
Yamamoto M, Adachi H, Enomoto M et al. Lower albumin levels are associated with frailty measures, trace elements, and an inflammation marker in a cross-sectional study in Tanushimaru. Environ Health Prevent Med 2021; 26: 25.
Matsuo S, Imai E, Horio M et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009; 53: 982-992.
An official website of the European Union. Over 27 million people aged 80 and over in the EU [online]; 2023. Available from: https://ec.europa.eu/eurostat/web/products-eurostat-news/-/EDN-20170930-1 [accessed 31 March 2023].
An official website of the United States government. Actuarial life table [online]; 2023. Available from: https://www.ssa.gov/oact/STATS/table4c6.html [accessed 31 March 2023].
Ministry of Health Labour and Welfare, Japan. Life expectancies at specified ages, 2023. Available from: https://www.mhlw.go.jp/english/database/db-hw/lifetb20/dl/lifetb20-01.pdf [accessed 31 March 2023].
Romain G, Mariet AS, Jooste V et al. Long-term relative survival after stroke: the Dijon stroke registry. Neuroepidemiology 2020; 54: 498-505.
Sorenson TJ, Vine R, Lanzino G. Unruptured intracranial aneurysms in patients over 80 years: natural history and management implications. Acta Neurochirurgica (Wien) 2018; 160: 1773-1777.
Macciò A, Madeddu C, Gramignano G et al. The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observational study. Haematologica 2015; 100: 124-132.
Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 2001; 91: 2214-2221.
Zhang Y, Chen Y, Chen D et al. Impact of preoperative anemia on relapse and survival in breast cancer patients. BMC Cancer 2014; 14: 844.
Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the national VA surgical risk study. Arch Surg 1999; 134: 36-42.
Ministry of Health Labour and Welfare, Japan. Vital statistics, 2022. Available from: https://www.e-stat.go.jp/dbview?sid=0003411659 [accessed 31 March 2023].
Public Health England. Death in people aged 75 years and older in England in 2017, 2019. Available from: https://www.gov.uk/government/publications/death-in-people-aged-75-years-and-older-in-england-in-2017/death-in-people-aged-75-years-and-older-in-england-in-2017 [accessed 31 March 2023].
Heron M. Deaths: leading causes for 2019. Natl Vital Stat Rep 2021; 70: 1-114.