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
5751 - Phase 3 ALTA-3 study of brigatinib (BRG) vs alectinib (ALC) in patients (pts) with advanced anaplastic lymphoma kinase (ALK)−positive non–small cell lung cancer (NSCLC) that progressed on crizotinib (CRZ)
Presenter: Sanjay Popat
Session: Poster Display session 1
Resources:
Abstract
5103 - CANOPY phase 3 program: Three studies evaluating canakinumab in patients with non-small cell lung cancer (NSCLC)
Presenter: Luis Paz-Ares
Session: Poster Display session 1
Resources:
Abstract
3666 - The Elderly Patient Individualized Chemotherapy (EPIC) trial, a study for an aged population of non-small cell lung cancer.
Presenter: Francesco Passiglia
Session: Poster Display session 1
Resources:
Abstract
4799 - KEYNOTE-495/KeyImPaCT: A Randomized, Biomarker-Directed, Phase 2 Trial of Pembrolizumab-Based Therapy for Non–Small Cell Lung Cancer (NSCLC)
Presenter: Martin Gutierrez
Session: Poster Display session 1
Resources:
Abstract
6035 - Safety, tolerability and activity of autologous T cells with enhanced T-cell receptors specific to NY ESO 1/LAGE 1a (GSK3377794) alone, or in combination with pembrolizumab, in advanced non small cell lung cancer: A Phase 1b/2a randomised pilot study
Presenter: Karen Reckamp
Session: Poster Display session 1
Resources:
Abstract
2176 - IFCT-1701 DICIPLE: a randomized phase 3 trial comparing continuation Nivolumab-Ipilimumab doublet immunotherapy until progression versus observation in patients with PDL1-positive stage IV Non-Small Cell Lung Cancer (NSCLC) after Nivolumab-Ipilimumab induction treatment
Presenter: Gerard Zalcman
Session: Poster Display session 1
Resources:
Abstract
2352 - ATALANTE-1 randomized phase 3 trial, OSE-2101 versus standard treatment as second or third line in HLA-A2 positive advanced non-small cell lung cancer (NSCLC) patients
Presenter: Enriqueta Felip
Session: Poster Display session 1
Resources:
Abstract
2451 - Phase Ib dose-escalation/expansion study of BI 836880, a VEGF/Ang2-blocking nanobody®, in combination with BI 754091, an anti-PD-1 antibody, in patients with advanced solid tumours
Presenter: Nicolas Girard
Session: Poster Display session 1
Resources:
Abstract
4285 - Radiosurgery followed by Tumor Treating Fields (TTFields) for brain metastases (1-10) from NSCLC in the phase 3 METIS trial
Presenter: Minesh Mehta
Session: Poster Display session 1
Resources:
Abstract
4909 - Nivolumab plus ipilimumab (NI) versus chemotherapy plus nivolumab (CN) in squamous cell lung cancer (SqCLC): the SQUINT trial
Presenter: Lorenza Landi
Session: Poster Display session 1
Resources:
Abstract