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
5054 - Inhibition of Rspo-Wnt pathway Facilitates Checkpoint Blockade Therapy by anti-RSPO3 antibody (DBPR117)
Presenter: John Hsu
Session: Poster Display session 1
Resources:
Abstract
3305 - A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumors
Presenter: Jürgen Krauss
Session: Poster Display session 1
Resources:
Abstract
5353 - Phase 1/2 Study of 9-ING-41, a small molecule selective Glycogen Synthase Kinase-3 Beta (GSK-3β) Inhibitor, as a Single Agent and Combined with Chemotherapy, in Patients with Refractory Hematological Malignancies or Solid Tumors
Presenter: Benedito Carneiro
Session: Poster Display session 1
Resources:
Abstract
3946 - Trial in progress: a Phase I, open-label study of GSK1795091 administered in combination with immunotherapies in participants with advanced solid tumors (NCT03447314).
Presenter: Aaron Hansen
Session: Poster Display session 1
Resources:
Abstract
3449 - Radiographic Phenotyping to Identify Intracranial Disseminated Recurrence in Brain metastases Treated With Radiosurgery Using Contrast-enhanced MR Imaging
Presenter: CheYu Hsu
Session: Poster Display session 1
Resources:
Abstract
4553 - Association between TP53 mutations and efficacy of Osimertinib for brain metastasis from EGFR-mutant lung cancer
Presenter: Lijuan Chen
Session: Poster Display session 1
Resources:
Abstract
4942 - Response assessment of melanoma brain metastases treated by stereotactic radiotherapy or immunotherapy or both: a comparison of RECIST 1.1, RANO and iRANO criteria
Presenter: Emilie Le Rhun
Session: Poster Display session 1
Resources:
Abstract
3529 - Management of multiple brain metastases by Staged SRS focusing on utmost risk lesions
Presenter: shaoqun Li
Session: Poster Display session 1
Resources:
Abstract
5315 - Whole brain radiotherapy plus simultaneous in-field boost versus whole brain radiotherapy plus fractionated stereotactic radiotherapy for multiple brain metastases of non-small cell lung cancer
Presenter: Lu Li
Session: Poster Display session 1
Resources:
Abstract
1116 - 3D based texture analysis serving as potential diagnostic factor in discriminating primary central nervous system lymphoma from metastatic brain tumors: A preliminary study
Presenter: Wen Guo
Session: Poster Display session 1
Resources:
Abstract