BJMO - volume 19, issue 1, january 2025
C. Van De Wyngaert MD, A. Werion MD, J. Mesland MD, C. van Marcke MD, PhD
The proportion of cancer patients considered for admission in intensive care units (ICU) gradually increased over the last decades. In this situation, it is important to avoid inappropriate management, whether through refusal of admission that could be beneficial, or through futile therapeutic escalation. In this review, we describe the factors that medical oncologists and intensive carers should discuss when considering ICU admission for cancer patients and propose a framework for decision-making based on four important concepts. Among cancer patients, data strongly suggest that the short-term prognosis is more linked to the acute pathology than to the underlying active tumour. More specifically, the impairment of more than two vital organs and the requirement of organ support are the most important factors predictive of mortality. ECOG performance status furthermore remains a crucial prognostic factor to consider. Open discussions with patients and close relatives at cancer diagnosis and during treatment are mandatory for informed decision making during an acute event.
(BELG J MED ONCOL 2025;19(1): 4–10)
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