Clinical impact of cerebral infarction in patients with non-small cell lung cancer

Background Lung cancer patients have a high risk of cerebral infarction, but the clinical significance of cerebral infarction in advanced non-small cell lung cancer (NSCLC) remains unclear. This study aimed to comprehensively investigate the incidence, prognostic impact, and risk factors of cerebral...

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Published in:International journal of clinical oncology 2022-05, Vol.27 (5), p.863-870
Main Authors: Anai, Moriyasu, Saruwatari, Koichi, Ikeda, Tokunori, Oda, Seitaro, Tajima, Yuka, Jodai, Takayuki, Sakata, Shinya, Iyama, Shinji, Tomita, Yusuke, Saeki, Sho, Ichiyasu, Hidenori, Sakagami, Takuro
Format: Article
Language:English
Subjects:
Asymptomatic
C-reactive protein
Cancer Research
Carcinoma, Non-Small-Cell Lung - drug therapy
Cerebral infarction
Cerebral Infarction - diagnostic imaging
Cerebral Infarction - etiology
Humans
Lung cancer
Lung Neoplasms - drug therapy
Magnetic resonance imaging
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local
Non-small cell lung carcinoma
Oncology
Original Article
Patients
Prognosis
Regression analysis
Retrospective Studies
Risk factors
Small cell lung carcinoma
Surgical Oncology
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Summary:Background Lung cancer patients have a high risk of cerebral infarction, but the clinical significance of cerebral infarction in advanced non-small cell lung cancer (NSCLC) remains unclear. This study aimed to comprehensively investigate the incidence, prognostic impact, and risk factors of cerebral infarction in patients with NSCLC. Methods We retrospectively examined 710 consecutive patients with advanced or post-operative recurrent NSCLC treated between January 2010 and July 2020 at Kumamoto University Hospital. Cerebral infarction was diagnosed according to the detection of high-intensity lesions on diffusion-weighted magnetic resonance imaging regardless of the presence of neurological symptoms during the entire course from 3 months before NSCLC diagnosis. The prognostic impact and risk factors of cerebral infarction were evaluated based on propensity score matching (PSM) and multivariate logistic regression analysis. Results Cerebral infarction occurred in 36 patients (5%). Of them, 21 (58%) and 15 (42%) patients developed asymptomatic and symptomatic cerebral infarction, respectively. PSM analysis for survival showed that cerebral infarction was an independent prognostic factor (hazards ratio: 2.45, 95% confidence interval (CI): 1.24–4.85, P  = 0.010). On multivariate logistic regression analysis, D-dimer (odds ratio [OR]: 1.09, 95% CI 1.05–1.14, P  
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-022-02132-w