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. 2019 Apr;10(2):292-299.
doi: 10.21037/jgo.2018.10.11.

Intensive care for patients with gastric cancers: outcome and survival prognostic factors

Hugo Herrscher  1   2 , Thierry Artzner  1   2 , François Severac  3 , François Faitot  4 , Jean-Emmanuel Kurtz  2   5 , Ralph Janssen-Langenstein  1 , Quentin Maestraggi  1   2 , Francis Schneider  1   2   6 , Baptiste Michard  1   2
Affiliations

Intensive care for patients with gastric cancers: outcome and survival prognostic factors

Hugo Herrscher et al. J Gastrointest Oncol. 2019 Apr.

Abstract

Background: Admission and management of patients with solid malignancies in intensive care unit (ICU) is a controversial topic. To this day, there is no data published concerning patients with gastric cancers hospitalized in ICU. This single center retrospective study reports the characteristics, outcome and prognostic factors of patients hospitalized in ICU for medical reasons over a period of 10 years.

Methods: We performed a single center retrospective study which reports the characteristics, outcome and prognostic factors of patients hospitalized in ICU for medical reasons over a period of 10 years.

Results: Thirty-seven patients were included, among whom 24 (64.9%) had metastatic cancer. The most frequent diagnosis on admission was septic shock (48.6%) and 24 patients (64.9%) required intubation. Ten patients (27.0%) were alive 3 months after their admission in ICU. Metastatic cancer and intubation were independently associated with a higher risk of dying within 3 months of admission in multivariate analysis: odds ratio (OR) =13.7; 95% confidence interval (CI), 1.7-108 (P<0.01). Seventeen patients (45.9%) died during their ICU stay. Metastatic cancer: OR =89; 95% CI, 2.7-6,588, therapeutic intensification: OR =1,471; 95% CI, 9.8-811,973 and the logistic organ dysfunction score (LODS) on admission: OR =1.4; 95% CI, 1.1-2.3 were independently associated with mortality within the ICU in multivariate analysis (P<0.01).

Conclusions: This is the first study that examines the outcome and prognostic factors of patients with gastric cancers who require life-sustaining therapy in ICU. The identification of 3 months and ICU mortality prognostic factors could contribute to guiding clinicians in the management of these patients and assist health professionals in their discussions with these patients and their families.

Keywords: Gastric cancer; intensive care; intubation; metastatic; outcome; prognostic.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow-chart for the selection of patients admitted in our intensive care unit for medical reason between 2007 and 2017. ICU, intensive care unit; SAPS, Simplified Acute Physiology Score.
Figure 2
Figure 2
Kaplan-Meier curves and estimates of 90-day survival following intensive care unit admission depending on intubation status and the presence of metastasis. P<0.001.
See this image and copyright information in PMC

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