Predicting reprisal of solid cancer treatment and 60-month survival after Medical Intensive Care. A single-centre cohort study.

Abstract

Introduction: Our study aimed to identify relevant features associated with the reprisal of antineoplastic treatment in patients with solid cancers after unplanned admittance to the intensive care unit (ICU) and to assess 60th-month survival in patients with solid neoplasms admitted to the ICU.

Methods: This single-centre retrospective study of critically ill patients with active cancers was performed over a 13-year period (2005-2018). Patients' characteristics, overall survival and antineoplastic treatment reprisal were extracted from digital medical files and compared.

Results: 134 patients were included in the study. Solid neoplasms were mostly localised to the head and neck (n=53) followed by lung cancers (n=29). Sepsis was the leading cause of ICU admission (62.1%) with 41/82 patients presenting with septic shock. Antineoplastic treatments were resumed in 40 patients. An age ≤60 years and an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤1 were found to be predictors for treatment reprisal, with odd ratios of, respectively, 2.83 (95%CI, 1.15-6.99) and 5.45 (95%CI, 2.01-14.82); area under the ROC curve of 72% (95%CI, 63-81%). Survival after the immediate discharge from the ICU was 101/134 (75%) and the 60-month survival rate was 29% and significantly higher in the treatment-reprisal group.

Conclusions: Age and ECOG PS were found to be predictors for treatment reprisal in patients with solid neoplasms admitted to the ICU. The latter benefit from better long-term survival.