Abstract 4077
Background
With increased incidence and survival of cancer patients (pts), more oncological candidates are considered for admission in Intensive Care Unit (ICU). Trials demonstrated no significant difference in the outcome of cancer pts compared to non-cancer pts. Our study describes characteristics and outcomes of cancer pts in a polyvalent ICU in Portugal.
Methods
Single-centre retrospective cohort study of consecutive oncological pts admitted to a polyvalent ICU (January 2013 to December 2017). Only pts with active cancer were included. A Cox model was fit with time to death within 6 months as the dependent variable and type of cancer and organ support therapy as the independent ones. Covariate Cox regressions were performed. ROC curve analysis was used to determine the sensitivity of prognostic scores.
Results
Two hundred and thirty-six pts included (1400 ICU admissions), mean age of 53.5 ± 15.3 years and 65% were male. Median length of stay was 3 days (IQR 5). Central nervous system (CNS - 31%), gastrointestinal (18%), genitourinary (17%) and hematological (H - 15%) were the main types of cancer. Curative/diagnostic surgeries (49%) and sepsis (17%) were the main reasons for admission. Vasopressors (VP), invasive mechanical ventilation (IMV) and renal replacement therapy (RRT) >24h were required in 31, 33 and 14% of pts. ICU mortality was 16%, those requiring VP, IMV or RRT were 45, 43 and 67%. Overall survival (OS) was 5.7 months, survival rate at 6 months was 48%. APACHE II and SAPS II scores in H-pts vs solid tumors (ST): 30 vs 20 and 63 vs 38, respectively, p < 0.005; ROC curve analysis with AUC > 0.72. VP, IMV, and RRT were more used in H-pts rather than ST-pts - excluding CNS - (71% vs 35%, p < 0.005; 63% vs 39%, p = 0.013; 29% vs 8%, p = 0.002; 46% vs 13% p < 0.005). Length of stay was longer in H-pts vs ST-pts (12.8 vs 7 days, p = 0.002) as ICU mortality (57% vs 14%, p < 0.005). Median OS in H-pts was 3.1 months and in ST-pts 13.9 months (p < 0.005).
Conclusions
Survival rate at 6 months was better than described in literature. Prolonged ICU stay was associated to worse prognosis, as use of support therapies. A better OS was documented in ST-pts. Both SAPS II and APACHE II scores were reasonably sensible predicting mortality, demonstrating their value in cancer pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Tiago Cruz Tomás.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4242 - HIV, HBV and HCV screening practices in oncology: a cross-sectional interregional survey
Presenter: Isabelle Poizot-Martin
Session: Poster Display session 1
Resources:
Abstract
1267 - Genetic landscape of KEAP1 and NFE2L2 mutated cancers from the AACR GENIE database
Presenter: Mark Zaki
Session: Poster Display session 1
Resources:
Abstract
878 - β-arrestin1 is involved in the Ras-induced malignant transformation
Presenter: Takashi Shibano
Session: Poster Display session 1
Resources:
Abstract
4143 - Incidence of second cancer among PLWHIV: retrospective observational study of a series of 601 patients in the French CANCERVIH network
Presenter: Jean-Philippe Spano
Session: Poster Display session 1
Resources:
Abstract
5145 - A challenging task – Identifying carcinoma of unknown primary (CUP) patients according to ESMO guidelines: the CUPISCO trial experience
Presenter: Chantal Pauli
Session: Poster Display session 1
Resources:
Abstract
1737 - Incidence and Outcome of chronic lymphocytic leukemia with Deletion 17p: An Indian experience; challenges and opportunities
Presenter: Ajay Gogia
Session: Poster Display session 1
Resources:
Abstract
2596 - Driving solo? Investigation into collaborating mutations in SDH-deficient neoplasia
Presenter: Jonathan Killian
Session: Poster Display session 1
Resources:
Abstract
1499 - The potential of a novel antiangiogenic VEGFR1-D2 binding peptide in oncology therapeutics
Presenter: Afsaneh Sadre Momtaz
Session: Poster Display session 1
Resources:
Abstract
1775 - First-in-human phase I study of TAS-117, an allosteric AKT inhibitor, in patients with advanced solid tumors
Presenter: Mayu Yunokawa
Session: Poster Display session 1
Resources:
Abstract
4584 - First-in-human study of ABBV-621 in patients (pts) with previously treated sold tumors: Dose-optimization cohorts
Presenter: Emiliano Calvo
Session: Poster Display session 1
Resources:
Abstract