Risk Factors and Prognosis of Stroke in Gynecologic Cancer Patients

SIMPLE SUMMARY: The impact of stroke on patients with cancer is of significant concern, as gynecologic oncologists occasionally face medical challenges in managing patients who experience stroke during cancer treatment. However, the relationship between stroke and gynecological cancers has not been sufficiently explored. Here, we evaluated the risk factors for stroke in patients with three major types of gynecological cancers and their effects on cancer prognosis. Out of the 644 patients, 54 (8.4%) experienced a stroke, which is notably higher than the 2% of stroke occurrence rate in the general population. Stroke is significantly associated with age and hypertension. Contrary to our initial concerns, stroke was not found to be an independent prognostic factor for progression-free or overall survival. These findings suggest the importance of an appropriate management plan that considers the age, medical history, and tumor characteristics of the patient, rather than an excessive concern about stroke itself. ABSTRACT: Increased life expectancy and cancer prevalence rates expose patients to a higher risk of developing other comorbidities such as stroke. This study aimed to evaluate the risk factors for and prognosis of stroke in patients with gynecological cancers. A single-center retrospective cohort study was conducted on patients with cervical, endometrial, and epithelial ovarian cancers. Patients were classified into three groups based on the period of stroke onset: at least one year before cancer diagnosis, within one year before cancer diagnosis to six months after the last treatment date, and six months after the last treatment date. Among the 644 patients, stroke occurred in 54 (8.4%). In univariate analysis, stroke was significantly associated with overall survival. In contrast, in multivariate analysis, stroke was significantly associated with age and hypertension, but not with overall survival. Age, pulmonary thromboembolism/deep vein thrombosis, histological grade, and tumor stage were significantly associated with overall survival. Therefore, it is important to establish an appropriate examination and treatment plan for patients with gynecologic cancers using a multidisciplinary approach that incorporates the patient’s age, medical condition, and tumor characteristics rather than excessively considering the adverse effects of stroke on cancer prognosis.