Northern Journal of ISA

Open Access Open Access  Restricted Access Subscription Access

Challenges of Cancer Staging and Therapy in Critically Ill Patients


Affiliations
1 Anaesthesiology and Intensive Care, GSMCH, Banur, Patiala, Punjab, India
2 Anaesthesiology and Intensive care, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India

The number of patients diagnosed with malignancy has increased significantly with the advent of new diagnostic modalities, so has the overall prognosis with the dawn of new therapeutic interventions. However many of these patients require critical care admissions as an aftermath of cancer or its treatment. There still exists a dilemma as to which cancer patients to admit and when to admit. The purpose of this review is therefore to outline principles of critical care in cancer patients with special emphasis on critical and palliative care as well as appraisal of economic and ethical aspects in their management.

Keywords

Cancer, Critical Care, Intensive Care Unit (ICU), Prognostic Factors.
User
Notifications
Font Size

  • Jermal A, Seigel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics. CA Cancer J Clin. 2008 Mar-Apr; 58(2):71-96. https://doi.org/10.3322/CA.2007.0010 PMid:18287387.

  • Azoulay E, Pochard F, Chevret S, Vinsonneau C, Garrouste M, Cohen Y, et al. Compliance with triage to intensive care recommendations. Crit Care Med. 2001; 29:2132-6. https://doi.org/10.1097/00003246200111000-00014 PMid:11700409.

  • Azoulay E, Mokart D, Lambert J, Lemiale V, Rabbat A, Kouatchet A, et al. Diagnostic strategy for hematology and oncology patients with acute respiratory failure: randomized controlled trial. Am J Respir Crit Care Med. 2010; 182:1038-46. https://doi.org/10.1164/rccm.201001-0018OC PMid:20581167.

  • von Bergwelt-Baildon M, Hallek MJ, Shimabukuro-Vornhagen AA, Kochanek M. CCC meets ICU: redefining the role of critical care of cancer patients. BMC Cancer. 2010; 10:612. https://doi.org/10.1186/1471-2407-10-612 PMid:21059210 PMCid:PMC2992522.

  • Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE-acute physiology and chronic health evaluation: A physiologically based classification system. Crit Care Med. 1981; 9:591-7. https://doi.org/10.1097/00003246-198108000-00008 PMid:7261642.

  • Le Gall JR, Lemenshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/ North American multicenter study. JAMA. 1993; 270:2957-63. https://doi.org/10.1001/jama.1993.035102400690357 PMid:8254858.

  • Bajwa SS, Bajwa SK, Kaur J. Care of terminally Ill cancer patients: An intensivist's dilemma. Indian J Palliat Care. 2010; 16:83-9. https://doi.org/10.4103/0973-1075.73671 PMid:21811354 PMCid:PMC3144437.

  • Berghmans T, Paesmans M, Sculier JP. Is a specific oncological scoring system better at predicting the prognosis of cancer patients admitted for an acute medical complication in an intensive care unit than general gravity scores? Support Care Cancer. 2004; 12:234-9. https://doi.org/10.1007/s00520-003-0580-3 PMid:14740281.

  • Groeger JS, White P Jr, Nierman DM, Glassman J, Shi W, Horak D, et al. Outcome of cancer patients requiring mechanical ventilation. J Clin Oncol. 1999; 17:991-7. https://doi.org/10.1200/JCO.1999.17.3.991 PMid:10071294.

  • Scott PH et al. Survival following mechanical ventilation of receipients of bone marrow and peripheral blood stem cell transplants. Anaesth Intensive Care. 2002; 30:289-234. https://doi.org/10.1177/0310057X0203000336 PMid:12075635.

  • Huaringa AJ et al. Outcome of bone marrow transplantation patients requiring mechanical ventilation. Crit Care Med. 2000; 28:1014-7. https://doi.org/10.1097/00003246-200004000-00017 PMid:10809275.

  • Soares M, Carvalho MS, Salluh JI, Ferreira CG, Luiz RR, Rocco JR, et al. Efect of age on survival of critically ill cancer patients. Crit Care Med. 2006; 34:715-721. https://doi.org/10.1097/01.CCM.0000201883.05900.3F PMid:16521261.

  • Bach PB, Schrag D, Nierman DM, Horak D, White Jr P, et al. Identification of poor prognostic features among patients requiring mechanical ventilation after hematopoietic stem cell transplantation. Blood. 2001; 98:3234-3240. https://doi.org/10.1182/blood.V98.12.3234 PMid:11719359.

  • Puxty K, McLoone P, Quasim T, Kinsella J, Morrison DS. Risk of critical illness among patients with solid cancers: a population-based observational study. JAMA Oncol. 2015; 1:1078-85. https://doi.org/10.1001/jamaoncol.2015.2855 PMid:26313462.

  • Schellongowski P, Sperr WR, Wohlfarth P, Knobl P, Rabitsch W, Watzke Herbert H. Critically ill patients with cancer: chances and limitations of intensive care medicine- a narrative review. ESMO open. 2016; 1:e000018. https://doi.org/10.1136/esmoopen-2015-000018 PMid:27843637 PMCid:PMC5070251.

  • Park HY, Suh GY, Jeon K, Koh W-J, Chung MP, Kim H, et al. Outcome and prognostic factors of patients with acute leukemia admitted to the intensive care unit for septic shock. Leukemia Lymphoma. 2008; 49:1929-34. https://doi.org/10.1080/10428190802353609 PMid:18949617.

  • Lahoti A, Kantarjian H, Salahudeen AK, Ravandi F, Cortes JE, Faderl S, et al. Predictors and outcome of acute kidney injury in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome. Cancer. 2010; 116:4063-8. https://doi.org/10.1002/cncr.25306 PMid:20564156 PMCid:PMC4181579.

  • Lameire NH, Flombaum CD, Moreau D, Ronco C. Acute renal failure in cancer patients. Ann Med. 2005; 37:13-25. https://doi.org/10.1080/07853890510007205 PMid:15902843.

  • Legriel S, Marijon H, Darmon M, Lemiale V, Bedos JP, Schlemmer B, et al. Central neurological complications in critically ill patients with malignancies. Intensive Care Med. 2010; 36:232-240. https://doi.org/10.1007/s00134-009-1709-8 PMid:19908028.

  • Massion PB, Dive AM, Doyen C, Bulpa P, Jamart J,Bosly A, et al. Prognosis of hematologic malignancies does not predict intensive care unit mortality. Crit Care Med. 2002; 30:2260-2270. https://doi.org/10.1097/00003246-200210000-00014 PMid:12394954.

  • Williams MD, Braun LA, Cooper LM, Johnston J, Weiss RV, Qualy RL, et al. Hospitalized cancer patients with severe sepsis: analysis of incidence, mortality and associated costs of care. Crit Care. 2004; 8: R291-R298. https://doi.org/10.1186/cc2893 PMid:15469571 PMCid:PMC1065011.

  • Soares M, Sailuh JI, Spector N, Rocco JR. Characteristics and outcome of cancer patients requiring mechanical ventillatory support for gt;24 hrs. Crit Care Med. 2005; 33(3):520-6. https://doi.org/10.1097/01.CCM.0000155783.46747.04 PMid:15753742.

  • Yancik R, Ganz PA, Varricchio CG, Conley B. Perspectives on comorbidity and cancer in older patients: Approaches to expand the knowledge base. J Clin Oncol. 2001; 19:1147-51. https://doi.org/10.1200/JCO.2001.19.4.1147 PMid:11181680.

  • Soares M, Salluh JI, Ferreira CG, Luiz RR, Spector N, Rocco JR. Impact of comorbidities on the six-month mortality of critically ill cancer patients. Intensive Care Med. 2005; 31:408-15. https://doi.org/10.1007/ s00134-005-2554-z PMid:15678310.

  • Azoulay E, Thiery G, Chevret S, Moreau D, Darmon M, Bergeron A, et al. The prognosis of acute respiratory failure in critically ill cancer patients. Medicine (Baltimore). 2004; 83:360-370. https://doi.org/10.1097/01.md.0000145370.63676.fb PMid:15525848.

  • Adda M, Coquet I, Darmon M, Thiery G, Schlemmer B, Azoulay E. Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med. 2008; 36:2766-2772. https://doi.org/10.1097/CCM.0b013e31818699f6 PMid:18766110.

  • Molina R, Bernal T, Borges M, Zaragoza R, Bonastre J, Granada RM, et al. Ventilatory support in critically ill hematology patients with respiratory failure [serial online]. Crit Care. 2012; 16:R133. https://doi.org/10.1186/cc11438 PMid:22827955 PMCid:PMC3580718.

  • Ferreira JC, Medeiros P Jr, Rego FM, Caruso P. Risk factors for noninvasive ventilation failure in cancer patients in the intensive care unit: a retrospective cohort study. J Crit Care. 2015; 30:1003-1007. https://doi.org/10.1016/j.jcrc.2015.04.121 PMid:26072388.

  • Epstein AS, Hartridge-Lambert SK, Ramaker JS, Voigt LP, Portlock CS. Humidified high-flow nasal oxygen utilization in patients with cancer at Memorial Sloan-Kettering Cancer Center. J Palliat Med. 2011; 14:835-839. https://doi.org/10.1089/jpm.2011.0005 PMid:21599530 PMCid:PMC5586152.

  • Darmon M, Thiery G, Ciroldi M, Galicier L, Raffox E, et al. Intensive care in patients with newly diagnosed malignancies and a need for cancer chemotherapy. Crit Care Med. 2005; 33: 2488-2493 https://doi.org/10.1097/01.CCM.0000181728.13354.0A PMid:16276171.

  • Nazer LH, Hawari F, Al-Najjar T. Adverse drug events in critically ill patients with cancer: incidence, characteristics, and outcomes. J Pharm Pract. 2014; 27:208-213. https://doi.org/10.1177/0897190013513302 PMid:24319079.

  • Lee DW, Gardner R, Porter DL, Louis CU, Ahmed N, Jensen M, Grupp SA, Mackall CL. How I treat: current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014; 124(2):18895. https://doi.org/10.1182/blood-2014-05-552729 PMid:24876563 PMCid:PMC4093680.

  • Kroschinsky F, Stozel F, von Bohin Simone, Beutel Group, Kochanek M, Kiehl M, et al. Critical Care. 2017; 21: 89. https://doi.org/10.1186/s13054-017-1678-1 PMid:28407743 PMCid:PMC5391608.

  • 34. Kazaure HS, Roman SA, Rosenthal RA, Sosa JA. Cardiac arrest among surgical patients: an analysis of incidence, patient characteristics, and outcomes in ACSNSQIP. JAMA Surg. 2013; 148:14-21. https://doi.org/10.1001/jamasurg.2013.671 PMid:23324834.

  • Kjorstad OJ, Haugen DF. Cardiopulmonary resuscitation in palliative care cancer patients. Tidsskr Nor Laegeforen. 2013; 133:417-21. https://doi.org/10.4045/tidsskr.12.0378 PMid:23423208.

  • Reisfield GM, Wallace SK, Munsell MK, Webb FJ, Alvarez ER, Wilson GR. Survival in cancer patients undergoing in-hospital cardiopulmonary resuscitation. Resuscitation 2006; 71(2):152-60. https://doi.org/10.1016/j.resuscitation.2006.02.022 PMid:16987581.

  • Champigneulle B, Merceron S, Lemiale V, Geri G, Mokart D, Bruneel F, et al. What is the outcome of cancer patients admitted to the ICU after cardiac arrest? Results from a multicenter study. Resuscitation. 2015; 92:38-44. https://doi.org/10.1016/j.resuscitation.2015.04.011 PMid:25917260.

  • Khasawneh FA, Kamel MT, Abu-Zaid MI. Predictors of cardiopulmonary arrest outcome in a comprehensive cancer center intensive care unit [serial online]. Scand J Trauma Resusc Emerg Med. 2013; 21:18. https://doi.org/10.1186/1757-7241-21-18 PMid:23510300 PMCid:PMC3606609.

  • Danis M, Southerland LI, Garret JM, Smith JL, Hielema F, Pickard CG et al. A prospective study of advance directives for life sustaining care. N Engl J Med. 1991; 324:882-8. https://doi.org/10.1056/NEJM199103283241304 PMid:2000110.

  • Mani RK. End of life care in India. Intensive care Medicine. 2006; 32(7):1066-8. https://doi.org/10.1007/s00134-006-0185-7 PMid:16791670.

  • Kantarjian HM, Fojo T, Mathisen M, Zwelling LA. Cancer drugs in the United States: Justum Pretium- the just price. J Clin Oncol. 2013; 31:3600-4. https://doi.org/10.1200/JCO.2013.49.1845 PMid:23650428 PMCid:PMC3782152.

  • Wohlfarth P, Ullrich R, Staudinger T, et al. Extracorporeal membrane oxygenation in adult patients with hematologic malignancies and severe acute respiratory failure [serial online]. Crit Care. 2014; 18:R20. https:// doi.org/10.1186/cc13701 PMid:24443905 PMCid:PMC4055976.

  • Bajwa SS, Anand S, Kaur G. Anesthesia and cancer recurrences: The current knowledge and evidence. J Canc Res Ther. 2015; 11(15):52834. https://doi.org/10.4103/0973-1482.157321 PMid:26458577.

  • Moors I, Benoit DD. Time to look beyond one-year mortality in critically ill hematological patients? Crit Care. 2014; 18:107. https://doi.org/10.1186/cc13722 PMid:24517551 PMCid:PMC4056035.


Abstract Views: 478

PDF Views: 184




  • Challenges of Cancer Staging and Therapy in Critically Ill Patients

Abstract Views: 478  |  PDF Views: 184

Authors

Sukhminder Jit Singh Bajwa
Anaesthesiology and Intensive Care, GSMCH, Banur, Patiala, Punjab, India
Smriti Anand
Anaesthesiology and Intensive care, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India

Abstract


The number of patients diagnosed with malignancy has increased significantly with the advent of new diagnostic modalities, so has the overall prognosis with the dawn of new therapeutic interventions. However many of these patients require critical care admissions as an aftermath of cancer or its treatment. There still exists a dilemma as to which cancer patients to admit and when to admit. The purpose of this review is therefore to outline principles of critical care in cancer patients with special emphasis on critical and palliative care as well as appraisal of economic and ethical aspects in their management.

Keywords


Cancer, Critical Care, Intensive Care Unit (ICU), Prognostic Factors.

References