ABSTRACT NUMBER: ESOC2026A531 ISCHAEMIC STROKE AND CANCER: A RETROSPECTIVE REVIEW IN A COMPREHENSIVE STROKE CENTRE

Abstract Background and aims Management of ischaemic stroke in patients with cancer is often controversial. We describe clinical characteristics, treatment strategies and outcomes in patients with cancer presenting with ischaemic stroke. Methods Retrospective observational study of patients with ischaemic stroke and active cancer—defined as tumours on imaging or ongoing oncological treatment—admitted to the Stroke Unit of a Comprehensive Stroke Centre (April 2023 - March 2025). Results A total of 41 patients were included (59% male), mean age 69 ± 2.5 years. Median baseline mRS was 0 (R 0–4) and NIHSS 7 (R 0–25). Most frequent malignancies were lung and haematological cancer (24.4% each). Platinum-based chemotherapy (24.4%) and immunotherapy (17%) were most used. Fourteen patients (34%) had prior thromboembolic episodes, mainly pulmonary embolism (43%), with a mean interval of 54 days between events. Seven patients (17%) had multiterritorial infarctions. In nine cases (29%), cancer was the sole stroke aetiology. Large vessel occlusion occurred in 19 (46.3%), medium vessel occlusion in 13 (31.7%). Intravenous thrombolysis was given to 14%, and 32% underwent mechanical thrombectomy, with successful reperfusion (TICI 2C–3) in 46%. At discharge, antiplatelets were prescribed in 17 (41.5%) and anticoagulation in 11 (26.8%). At three months, 21 (51.2%) had mRS 0–2; and 12 (29.6%) were deceased, with one-quarter of deaths attributed exclusively to cancer. Conclusions Patients in this cohort had good premorbid functional status, moderate to severe stroke, and frequently recent prior thromboembolic events. At three months, more than half of the patients were functionally independent; however, mortality was high. Conflict of interest Nothing to disclose