Cerebral infarction in advanced non-small cell lung cancer: a case control study.

Motoyasu Kato,Ryota Kanemaru,Rina Shibayama,Ryo Koyama,Takehito Shukuya,Fumiyuki Takahashi,Yuta Nanjo,Naoko Shimada,Yuichiro Honma,Keiko Muraki,Kazuhisa Takahashi,Keita Mori

doi:10.1186/s12885-016-2233-1

Motoyasu Kato, Ryota Kanemaru + Show 10 more

Open Access

https://doi.org/10.1186/s12885-016-2233-1

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Journal: BMC Cancer	Publication Date: Mar 10, 2016
Citations: 25	License type: cc-by

Affiliation: Juntendo University, Shizuoka Cancer Center

Abstract

BackgroundAdvanced non-small cell lung cancer (NSCLC) patients often develop thromboembolic events, including cerebral infarction (CI). However, the relationship between advanced NSCLC and CI has not been thoroughly investigated. We examined the association between advanced NSCLC and CI and risk factors for CI in advanced or post-operative recurrent NSCLC patients.MethodsWe retrospectively investigated 515 patients diagnosed with advanced or post-operative recurrent NSCLC at Juntendo University Hospital between April 2009 and March 2014.ResultsAmong the 515 patients evaluated, 15 patients (2.9 %) developed CI after diagnosis of advanced or post-operative recurrent NSCLC. Univariate and multivariate analyses were conducted, and brain metastasis was the only significant independent risk factor for CI (odds ratio 5.24, 95 % confidence interval 1.72–16.10, p = 0.004). The incidence was 6.3 % in these patients. The median survival time was 36 days, and 1-year survival rate was 6.7 % after development of CI. Overall survival from diagnosis of advanced NSCLC or post-operative recurrence was significantly shorter in patients with CI than in patients without CI (223 days versus 895 days; HR, 3.46; 95 % confidence interval, 2.04–6.02; p = 0.001).ConclusionsThe incidence of CI is high in advanced or post-operative recurrent NSCLC, and is especially higher in patients with brain metastasis than in those without brain metastasis. Moreover, CI may affect patient’s prognosis. Careful monitoring for the development of CI in patients with advanced or post-operative recurrent NSCLC is needed, especially for patients with brain metastasis.

Highlights

Advanced non-small cell lung cancer (NSCLC) patients often develop thromboembolic events, including cerebral infarction (CI)
Overall survival (OS) from diagnosis of advanced NSCLC or post-operative recurrence was significantly shorter in patients with CI than in patients without CI (223 days versus 895 days; hazard ratio (HR), 3.46; 95 % confidence interval, 2.04–6.02; p = 0.001, Fig. 3)
In this study, we found that the incidence of CI was 2.9 % in advanced or post-operative recurrent NSCLC, and brain metastasis was the only risk factor for the development of CI in patients with advanced or postoperative recurrent NSCLC

Summary

Introduction

Advanced non-small cell lung cancer (NSCLC) patients often develop thromboembolic events, including cerebral infarction (CI). The relationship between advanced NSCLC and CI has not been thoroughly investigated. We examined the association between advanced NSCLC and CI and risk factors for CI in advanced or post-operative recurrent NSCLC patients. Cancer is the leading cause of death in the world. Nonsmall cell lung cancer (NSCLC) is one of the most aggressive diseases and has a poor prognosis compared with other malignancies. NSCLC patients are usually diagnosed at an advanced stage and usually receive chemotherapy. The prognosis of advanced NSCLC patients is improving due to the developments in chemotherapy, and better control of adverse events and complications is becoming more important. An association between cancer and thrombotic events was first reported by Trousseau in 1865 [1].

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