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Outcomes in Critically Ill Oncologic Patients

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Oncologic Critical Care
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Abstract

Cancer is the second leading cause of death globally, responsible for 8.8 million deaths in 2015. Globally, nearly 1 in 6 deaths is due to cancer. The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, classical intensive care unit (ICU) admission comorbidity criteria have been discouraging in this group of patients because the risk factors for death that have been studied, primarily the number of organ failures, allow us to understand the determinants of the prognosis inside the ICU. The number of cancer patients needing ICU care has increased both for cancer-related complications and for treatment-associated side effects. Approximately 13–22% of cancer patients will need admission to a general ICU, and only the 27% of ICU admissions are directly linked with cancer. Survival rates for patients with cancer who are admitted to the ICU have improved; therefore, admission should not be denied to patients only on the basis of their cancer diagnosis. Specialists who treat critically ill cancer patients should implement preventive measures to avoid in-hospital death of cancer patients, identifying them at an earlier stage of organ failures. ICU admission should help to prevent, detect, and treat organ dysfunction when offering full support to those cancer patients who are candidates for ICU admission to impact their final outcome. At present, treatment of these patients presents challenges for the oncologist, hematologist, surgical oncologist, and critical care specialist.

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References

  1. Azoulay E, Mokart D, Pène F, et al. Outcomes of critically ill patients with hematologic malignancies: prospective multicenter data from France and Belgium – a Groupe de Recherche Respiratoire en Reanimation Onco-Hematologique study. J Clin Oncol. 2013;31(22):2810–8.

    Article  Google Scholar 

  2. Al-Zubaidi N, Shehada E, Alshabani K, ZazaDitYafawi J, Kingah P, Soubani AO. Predictors of outcome in patients with hematologic malignancies admitted to the intensive care unit. Hematol Oncol Stem Cell Ther. 2018;11:206. pii: S1658-3876(18)30028-1 [Epub ahead of print].

    Article  Google Scholar 

  3. Benoit DD, Vandewoude KH, Decruyenaere JM, et al. Outcome and early prognostic indicators in patients with a hematologic malignancy admitted to the intensive care unit for a life-threatening complication. Crit Care Med. 2003;31(1):104–12.

    Article  Google Scholar 

  4. Bird GT, Farquhar-Smith P, Wigmore T, Potter M, Gruber PC. Outcomes and prognostic factors in patients with haematological malignancy admitted to a specialist cancer intensive care unit: a 5 yr study. Br J Anaesth. 2012;108(3):452–9.

    Article  CAS  Google Scholar 

  5. Bos MM, Verburg IW, Dumaij I, et al. Intensive care admission of cancer patients: a comparative analysis. Cancer Med. 2015;4(7):966–76.

    Article  Google Scholar 

  6. Bouteloup M, Perinel S, Bourmaud A, et al. Outcomes in adult critically ill cancer patients with and without neutropenia: a systematic review and meta-analysis of the Groupe de Recherche en Réanimation Respiratoire du patient d'Onco-Hématologie (GRRR-OH). Oncotarget. 2017;8(1):1860–70.

    Article  Google Scholar 

  7. Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002;346(4):235–42.

    Article  CAS  Google Scholar 

  8. Caruso P, Ferreira AC, Laurienzo CE, et al. Short- and long-term survival of patients with metastatic solid cancer admitted to the intensive care unit: prognostic factors. Eur J Cancer Care (Engl). 2010;19(2):260–6.

    Article  CAS  Google Scholar 

  9. Cárdenas-Turanzas M, Ensor J, Wakefield C, et al. Cross-validation of a sequential organ failure assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit. J Crit Care. 2012;27(6):673–80.

    Article  Google Scholar 

  10. Cornish M, Butler MB, Green RS. Predictors of poor outcomes in critically ill adults with hematologic malignancy. Can Respir J. 2016;2016:9431385.

    Article  Google Scholar 

  11. Contejean A, Lemiale V, Resche-Rigon M, et al. Increased mortality in hematological malignancy patients with acute respiratory failure from undetermined etiology: a Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologique (Grrr-OH) study. Ann Intensive Care. 2016;6(1):102.

    Article  Google Scholar 

  12. Darmon M, Thiery G, Ciroldi M, et al. Intensive care in patients with newly diagnosed malignancies and a need for cancer chemotherapy. Crit Care Med. 2005;33(11): 2488–93.

    Article  Google Scholar 

  13. Darmon M, Vincent F, Canet E, et al. Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie. Nephrol Dial Transplant. 2015;30(12):2006–13.

    Article  Google Scholar 

  14. Fisher R, Dangoisse C, Crichton S, et al. Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis. BMJ Open. 2016;6(10):e011363.

    Article  Google Scholar 

  15. Geerse DA, Span LF, Pinto-Sietsma SJ, van Mook WN. Prognosis of patients with haematological malignancies admitted to the intensive care unit: sequential organ failure assessment (SOFA) trend is a powerful predictor of mortality. Eur J Intern Med. 2011;22(1):57–61.

    Article  Google Scholar 

  16. Gilbert C, Vasu TS, Baram M. Use of mechanical ventilation and renal replacement therapy in critically ill hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2013;19(2):321–4.

    Article  Google Scholar 

  17. Grgić Medić M, Gornik I, Gašparović V. Hematologic malignancies in the medical intensive care unit–outcomes and prognostic factors. Hematology. 2015;20(5):247–53.

    Article  Google Scholar 

  18. Irie H, Otake T, Kawai K, et al. Prognostic factors in critically ill patients with hematological malignancy admitted to the general intensive care unit: a single-center experience in Japan. J Anesth. 2017;31(5): 736–43.

    Article  Google Scholar 

  19. Jackson K, Mollee P, Morris K, et al. Outcomes and prognostic factors for patients with acute myeloid leukemia admitted to the intensive care unit. Leuk Lymphoma. 2014;55(1):97–104.

    Article  Google Scholar 

  20. Koutsoukou A. Admission of critically ill patients with cancer to the ICU: many uncertainties remain. ESMO Open. 2017;2(4):e000105.

    Article  Google Scholar 

  21. Lamia B, Hellot MF, Girault C, et al. Changes in severity and organ failure scores as prognostic factors in onco-hematological malignancy patients admitted to the ICU. Intensive Care Med. 2006;32(10):1560–8.

    Article  CAS  Google Scholar 

  22. Legrand M, Max A, Peigne V, et al. Survival in neutropenic patients with severe sepsis or septic shock. Crit Care Med. 2012;40(1):43–9.

    Article  Google Scholar 

  23. Lee DS, Suh GY, Ryu JA, et al. Effect of early intervention on long-term outcomes of critically ill Cancer patients admitted to ICUs. Crit Care Med. 2015;43(7):1439–48.

    Article  CAS  Google Scholar 

  24. Mokart D, Lambert J, Schnell D, et al. Delayed intensive care unit admission is associated with increased mortality in patients with cancer with acute respiratory failure. Leuk Lymphoma. 2013;54(8):1724–9.

    Article  Google Scholar 

  25. Namendys-Silva SA, Herrera-Gómez A. Organ dysfunction in patients with cancer admitted to the intensive care unit. Crit Care Med. 2010;38(4):1232–3.

    Article  Google Scholar 

  26. Namendys-Silva SA, González-Herrera MO, García-Guillén FJ, et al. Outcome of critically ill patients with hematological malignancies. Ann Hematol. 2013;92(5):699–705.

    Article  Google Scholar 

  27. Namendys-Silva SA, Jarquin-Badiola YD, García-Guillén FJ, et al. Mechanical ventilation in critically ill cancer patients. Heart Lung. 2015;44(1):85–6.

    Article  Google Scholar 

  28. Nates JL, Nunnally M, Kleinpell R, et al. ICU admission, discharge, and triage guidelines: a framework to enhance clinical operations, development of institutional policies, and further research. Crit Care Med. 2016;44(8):1553–602.

    Article  Google Scholar 

  29. Ñamendys-Silva SA, Plata-Menchaca EP, Rivero-Sigarroa E, Herrera-Gómez A. Opening the doors of the intensive care unit to cancer patients: a current perspective. World J Crit Care Med. 2015;4(3): 159–62.

    Article  Google Scholar 

  30. Owczuk R, Wujtewicz MA, Sawicka W, Wadrzyk A, Wujtewicz M. Patients with haematological malignancies requiring invasive mechanical ventilation: differences between survivors and non-survivors in intensive care unit. Support Care Cancer. 2005;13(5):332–8.

    Article  Google Scholar 

  31. Pène F, Aubron C, Azoulay E, et al. Outcome of critically ill allogeneic hematopoietic stem-cell transplantation recipients: a reappraisal of indications for organ failure supports. J Clin Oncol. 2006;24(4): 643–9.

    Article  Google Scholar 

  32. Puxty K, McLoone P, Quasim T, Kinsella J, Morrison D. Survival in solid cancer patients following intensive care unit admission. Intensive Care Med. 2014;40(10):1409–28.

    Article  Google Scholar 

  33. Puxty K, McLoone P, Quasim T, et al. Characteristics and outcomes of surgical patients with solid cancers admitted to the intensive care unit. JAMA Surg. 2018;153(9):834–40.

    Article  Google Scholar 

  34. Regazzoni CJ, Irrazabal C, Luna CM, Poderoso JJ. Cancer patients with septic shock: mortality predictors and neutropenia. Support Care Cancer. 2004;12(12): 833–9.

    Article  Google Scholar 

  35. Scales DC, Thiruchelvam D, Kiss A, Sibbald WJ, Redelmeier DA. Intensive care outcomes in bone marrow transplant recipients: a population-based cohort analysis. Crit Care. 2008;12(3):R77.

    Article  Google Scholar 

  36. Sprung CL, Geber D, Eidelman LA, et al. Evaluation of triage decisions for intensive care admission. Crit Care Med. 1999;27(6):1073–9.

    Article  CAS  Google Scholar 

  37. Thiéry G, Azoulay E, Darmon M, et al. Outcome of cancer patients considered for intensive care unit admission: a hospital-wide prospective study. J Clin Oncol. 2005;23:4406–13.

    Article  Google Scholar 

  38. Taccone FS, Artigas AA, Sprung CL, et al. Characteristics and outcomes of cancer patients in European ICUs. Crit Care. 2009;13(1):R15.

    Article  Google Scholar 

  39. The World Health Organization. Cancer. 2018. http://www.who.int/news-room/fact-sheets/detail/cancer Accessed 31 Oct 2018.

  40. Vandijck DM, Benoit DD, Depuydt PO, et al. Impact of recent intravenous chemotherapy on outcome in severe sepsis and septic shock patients with hematological malignancies. Intensive Care Med. 2008;34(5): 847–55.

    Article  Google Scholar 

  41. Wohlfarth P, Staudinger T, Sperr WR, et al. Prognostic factors, long-term survival, and outcome of cancer patients receiving chemotherapy in the intensive care unit. Ann Hematol. 2014;93(10):1629–36.

    Article  CAS  Google Scholar 

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Correspondence to Silvio A. Ñamendys-Silva .

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Ñamendys-Silva, S.A. (2020). Outcomes in Critically Ill Oncologic Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74588-6_145

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  • DOI: https://doi.org/10.1007/978-3-319-74588-6_145

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74587-9

  • Online ISBN: 978-3-319-74588-6

  • eBook Packages: MedicineReference Module Medicine

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