OBJECTIVES The objective of this study was to estimate the incidence, timing, and type of new cancer diagnosis among patients with cryptogenic stroke. METHODS We used data from the ARCADIA trial, which enrolled patients with cryptogenic stroke and atrial cardiopathy. Participants were prospectively followed, and serious adverse events were assessed every 3 months or sooner if investigators were alerted between visits to an event. Kaplan-Meier statistics were used to estimate the cumulative incidence of a cancer diagnosis within the first year after randomization. RESULTS Among 878 participants without baseline history of cancer, 13 (1.5%) were diagnosed with incident cancer in the year after randomization, comprising 12 solid cancers (3 prostate, 2 breast, 2 gastrointestinal, and 5 other primary sites) and 1 hematologic cancer (non-Hodgkin lymphoma). The cumulative incidences of a cancer diagnosis were 0% at 3 months, 0.6% (95% CI 0.2%-1.5%) at 6 months, and 2.0% (95 CI 1.1%-3.4%) at 1 year. The median time from index stroke to cancer diagnosis was 261 days (interquartile range 183-358). DISCUSSION In a multicenter cryptogenic stroke cohort with prospective follow-up, the 1-year cumulative incidence of a cancer diagnosis was 2%. This rate may be an underestimation because of the clinical trial population and exclusion of cancers diagnosed immediately after stroke. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov Identifier: NCT03192215. Registered June 20, 2017. First patient enrolled February 1, 2018.

中文翻译：

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隐源性中风后新发癌症的诊断：ARCADIA 随机试验的探索性分析。


目的 本研究的目的是估计隐源性卒中患者新诊断癌症的发生率、时间和类型。方法 我们使用了 ARCADIA 试验的数据，该试验招募了隐源性卒中和心房心脏病患者。对参与者进行前瞻性随访，每 3 个月评估一次严重不良事件，如果研究人员在两次事件就诊之间得到提醒，则更早评估。Kaplan-Meier 统计用于估计随机分组后第一年内癌症诊断的累积发生率。结果 在无基线癌症病史的 878 名参与者中，13 名 （1.5%） 在随机分组后一年内被诊断为新发癌症，包括 12 名实体癌 （3 名前列腺癌、2 名乳腺癌、2 名胃肠道癌和 5 名其他原发部位）和 1 名血液系统癌症 （非霍奇金淋巴瘤）。癌症诊断的累积发生率在 3 个月时为 0%，在 6 个月时为 0.6% （95% CI 0.2%-1.5%），在 1 年时为 2.0% （95 CI 1.1%-3.4%）。从指数卒中到癌症诊断的中位时间为 261 天 （四分位距 183-358）。讨论 在前瞻性随访的多中心隐源性卒中队列中，癌症诊断的 1 年累积发生率为 2%。由于临床试验人群和排除了中风后立即诊断的癌症，这一比率可能被低估了。试验注册信息 ClinicalTrials.gov 标识符：NCT03192215。2017 年 6 月 20 日注册。2018 年 2 月 1 日入组了第一位患者。