Urologic oncology and critical care: What are prognostic factors that correlate with 6-month mortality in patients (pts) with urological tumors referred to intensive care unit (ICU)?

Authors

null

Giulia Kodja Zanetta

A.C. Camargo Cancer Center, São Paulo, Brazil

Giulia Kodja Zanetta , Antonio Paulo Nassar Jr , Aldo A. Dettino

Organizations

A.C. Camargo Cancer Center, São Paulo, Brazil

Research Funding

No funding received
None.

Background: Defining which oncologic pts actually benefit from ICU admission can be a difficult task. There is a lack of data that consistently support indication and benefit with impact on patient survival when this care is offered. The present retrospective study sought to evaluate prognostic factors related to mortality in 6 months after hospital discharge of pts with urological tumors admitted to ICU at the A C Camargo Cancer Center. Methods: A retrospective cohort study of pts with urological cancers (bladder, prostate, kidney, testicular, and other) admitted to ICU in 2017-2018. We collected the following data to identify possible predictors of 6-month mortality: gender, age, Eastern Cooperative Oncology Group (ECOG) performance status, type of ICU admission (planned or unplanned), clinical stage at diagnosis (locoregional vs. metastatic). All these variables were included in a logistic regression model with mortality at 6 months as the dependent variable. Results: Assessing the medical record of 677 patients, the pts with ECOG grading >2 presented poorer results compared to the ones 0-2, with an Odds Ratio (OR) 5.10 [Confidence Interval 95% (CI) 2.46-11.69]. The urological tumor type did influence the 6-month mortality, with the best results for pts with testicular tumors: OR 0.27 (CI 0.05-0.99) and the worst ones to bladder tumors with an OR 2.35 (CI 1.44-3.87) when compared to prostate tumors. For metastatic diagnoses, as expected, the mortality results appeared to be worse than for pts with locoregional disease, with an OR 4.06 (CI 2.73-6.07). Finally, pts undergoing unplanned hospitalization at ICU, understanding clinical and surgical ones, presented poorer results compared to the elective ones, with an OR 3.22 (2.16-4.84). Conclusions: In this cohort of pts with urological cancers, 6-month mortality was 39%. Performance status, bladder cancer, metastatic disease and unplanned hospitalizations were all associated with increased mortality.

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Abstract Details

Meeting

2023 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Prostate Cancer and Urothelial Carcinoma

Track

Urothelial Carcinoma,Prostate Cancer - Advanced

Sub Track

Quality of Care/Quality Improvement and Real-World Evidence

Citation

J Clin Oncol 41, 2023 (suppl 6; abstr 91)

DOI

10.1200/JCO.2023.41.6_suppl.91

Abstract #

91

Poster Bd #

D11

Abstract Disclosures

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