scholarly journals One-Year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

2020 ◽  
Author(s):  
Esther Nadine van der Zee ◽  
Fabian Termorshuizen ◽  
Dominique D. Benoit ◽  
Nicolette F. de Keizer ◽  
Jan Bakker ◽  
...  
Keyword(s):  
The Netherlands ◽  
Cancer Patients ◽  
Solid Tumour ◽  
Visual Inspection ◽  
Cohort Analysis ◽  
Mortality Rates ◽  
Icu Admission ◽  
Significant Difference ◽  
Inclusion Period

Abstract BackgroundOver the last decades, a decrease in short-term mortality in cancer patients admitted to the ICU has been described in literature. However, it is unclear whether this decrease also results in a decrease in long-term mortality. Therefore, we examined the 1-year mortality of cancer patients (either haematological or solid) with an unplanned ICU admission.Methods and dataAll adult patients registered in the National Intensive Care Evaluation registry with an unplanned ICU admission in the Netherlands between 2008 and 2017 were included. The primary outcome was 1-year mortality, analysed with a mixed-effects cox-proportional hazard regression. We examined the trend in mortality rates over the inclusion period. Furthermore, we compared the 1-year mortality of cancer patients to that of patients without cancer. ResultsWe included 470,305 patients: 10,401 with haematological cancer, 35,920 with solid tumours, and 423,984 without cancer. The 1-year mortality rates were 60.1%, 46.2%, and 28.3% (p<0.01), respectively. While no statistically significant trend was found (p=0.58), a visual inspection of the graph showed a slightly decreasing trend in 1-year mortality over the inclusion period. Although we found a statistical significant difference in 1-year mortality in patients with a solid tumour (p<0.01), visual inspection showed a wide variety per year. We found a decreasing trend in 1-year mortality in ICU patients without a malignancy (p<0.01). Cancer patients surviving their critical illness and hospital admission had a 30% mortality at 1 year. ConclusionThe 1-year mortality in cancer patients with an unplanned ICU admission (either haematological or solid) was significantly higher than that of patients without cancer. A visual inspection showed a slight decrease in 1-year mortality in haematological patients, while the 1-year mortality in patients with a solid tumour varied per year. After hospital discharge, a considerable part of the patients with a malignancy died within 1 year. Physicians should discuss the long-term prognosis after an ICU admission with patients and relatives in order to manage treatments and expectations. Future research should focus on identifying cancer patients who will benefit from an ICU admission.

scholarly journals One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

2021 ◽  
pp. 088506662110543
Author(s):  
Esther N. van der Zee ◽  
Fabian Termorshuizen ◽  
Dominique D. Benoit ◽  
Nicolette F. de Keizer ◽  
Jan Bakker ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
The Netherlands ◽  
Hospital Admission ◽  
Cancer Patients ◽  
Solid Cancer ◽  
Term Survival ◽  
Icu Admission ◽  
Over Time

Introduction: A decrease in short-term mortality of critically ill cancer patients with an unplanned intensive care unit (ICU) admission has been described. Few studies describe a change over time of 1-year mortality. Therefore, we examined the 1-year mortality of cancer patients (hematological or solid) with an unplanned ICU admission and we described whether the mortality changed over time. Methods: We used the National Intensive Care Evaluation (NICE) registry and extracted all patients with an unplanned ICU admission in the Netherlands between 2008 and 2017. The primary outcome was 1-year mortality, analyzed with a mixed-effects Cox proportional hazard regression. We compared the 1-year mortality of cancer patients to that of patients without cancer. Furthermore, we examined changes in mortality over the study period. Results: We included 470,305 patients: 10,401 with hematological cancer, 35,920 with solid cancer, and 423,984 without cancer. The 1-year mortality rates were 60.1%, 46.2%, and 28.3% respectively ( P< .01). Approximately 30% of the cancer patients surviving their hospital admission died within 1 year, this was 12% in patients without cancer. In hematological patients, 1-year mortality decreased between 2008 and 2011, after which it stabilized. In solid cancer patients, inspection showed neither an increasing nor decreasing trend over the inclusion period. For patients without cancer, 1-year mortality decreased between 2008 and 2013, after which it stabilized. A clear decrease in hospital mortality was seen within all three groups. Conclusion: The 1-year mortality of cancer patients with an unplanned ICU admission (hematological and solid) was higher than that of patients without cancer. About one-third of the cancer patients surviving their hospital admission died within 1 year after ICU admission. We found a decrease in 1-year mortality until 2011 in hematology patients and no decrease in solid cancer patients. Our results suggest that for many cancer patients, an unplanned ICU admission is still a way to recover from critical illness, and it does not necessarily lead to success in long-term survival. The underlying type of malignancy is an important factor for long-term outcomes in patients recovering from critical illness.

Acute kidney injury and major outcomes in cancer patients with no history of chronic kidney disease (CKD) with coronavirus 2019 (COVID-19) infection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18816-e18816
Author(s):  
Cesar Simbaqueba ◽  
Omar Mamlouk ◽  
Kodwo Dickson ◽  
Josiah Halm ◽  
Sreedhar Mandayam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Hazard Model ◽  
Cancer Center ◽  
Icu Admission ◽  
Significant Difference ◽  
History Of

e18816 Background: Acute Kidney Injury (AKI) in patients with COVID-19 infection is associated with poor clinical outcomes. We examined outcomes (hemodialysis, mechanical ventilation, ICU admission and death) in cancer patients with normal estimated glomerular filtration rate (eGFR) treated in a tertiary referral center with COVID-19 infection, who developed AKI within 30 days of diagnosis. Methods: All patient data — demographics, labs, comorbidities and outcomes — were aggregated and analyzed in the Syntropy platform, Palantir Foundry (“Foundry”), as part of the Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) protocol at MD Anderson. The cohort was defined by the following: (1) positive COVID-19 test; (2) baseline eGFR >60 ml/min/1.73m2most temporally proximal lab results within 30 days prior to the patient’s infection. AKI was defined by an absolute change of creatinine ≥0.3 within 30 days after the positive COVID-19 test. Kaplan-Meier analysis was used for survival estimates at specific time periods and multivariate Cox Proportional cause-specific Hazard model regression to determine hazard ratios with 95% confidence intervals for major outcomes. Results: 635 patients with Covid-19 infection had a baseline eGFR >60 ml/min/1.73m2. Of these patients, 124 (19.5%) developed AKI. Patients with AKI were older, mean age of 61+/-13.2 vs 56.9+/- 14.3 years (p=0.002) and more Hypertensive (69.4% vs 56.4%, p=0.011). AKI patients were more likely to have pneumonia (63.7% vs 37%, p<0.001), cardiac arrhythmias (39.5% vs 20.7%, p<0.001) and myocardial infarction (15.3% vs 8.8%, p=0.046). These patients had more hematologic malignancies (35.1% vs 19%, p=0.005), with no difference between non metastatic vs metastatic disease (p=0.284). There was no significant difference in other comorbidities including smoking, diabetes, hypothyroidism and liver disease. AKI patients were more likely to require dialysis (2.4% vs 0.2%, p=0.025), mechanical ventilation (16.1% vs 1.8%, p<0.001), ICU admission (43.5% vs 11.5%, p<0.001) within 30 days, and had a higher mortality at 90 days of admission (20.2% vs 3.7%, p<0.001). Multivariate Cox Proportional cause-specific Hazard model regression analysis identified history of Diabetes Mellitus (HR 10.8, CI 2.42 - 48.4, p=0.001) as an independent risk factor associated with worse outcomes. Mortality was higher in patients with COVID-19 infection that developed AKI compared with those who did not developed AKI (survival estimate 150 days vs 240 days, p=0.0076). Conclusions: In cancer patients treated at a tertiary cancer center with COVID-19 infection and no history of CKD, the presence of AKI is associated with worse outcomes including higher 90 day mortality, ICU stay and mechanical ventilation. Older age and hypertension are major risk factors, where being diabetic was associated with worse clinical outcomes.

Prognostic factors for medium- and long-term survival of esophageal cancer patients in the Netherlands

2013 ◽  
Vol 109 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Pauline Bus ◽  
Valery E. Lemmens ◽  
Martijn G. van Oijen ◽  
Geert-Jan Creemers ◽  
Grard A. Nieuwenhuijzen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
The Netherlands ◽  
Cancer Patients ◽  
Term Survival ◽  
Long Term Survival

Long-term cancer survival in cohorts of U.S. health professionals.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12075-12075
Author(s):  
En Cheng ◽  
Donghoon Lee ◽  
Rulla M Tamimi ◽  
Susan Hankinson ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cancer Patients ◽  
Health Professionals ◽  
Mortality Rates ◽  
Uterine Corpus ◽  
Specific Mortality ◽  
Colon And Rectum ◽  
Cancer Specific Mortality ◽  
Index Cancer

12075 Background: Few studies have investigated long-term survival and causes of death among men and women diagnosed with major cancers. Methods: We estimated overall and cause-specific mortality rates for men diagnosed with prostate, lung and bronchus, colon and rectum, bladder, and melanoma cancer in the Health Professionals Follow-up Study between 1986-2010+, and women with breast, lung and bronchus, colon and rectum, uterine corpus, thyroid, and ovarian cancer in the Nurses’ Health Study (NHS) between 1976-2010+ and NHS II between 1989-2010+. Kaplan-Meier curves were used to calculate cumulative mortality rates at 5, 10, 15, 20, and 30 years and competing risk methods were used to calculate cumulative cancer-specific mortality rates of major causes at 5, 10, 15, 20, and 30 years. Additionally, among women 40-year mortality rates were calculated. Results: Except for lung and ovarian, most major cancer patients are more likely to die from other causes than the index cancer. We observed two basic patterns for cumulative cancer-specific mortality rates. The first pattern is greatly diminished risk of index cancer-specific mortality 10 years or more following diagnosis - for colorectal cancer, cancer-specific mortality rate increased by less than 3% between 10 to 30- or 40-year following diagnosis (among men, from 35.1% to 36.7%; among women, from 34.8% to 37.7%), and this pattern also applied to bladder, melanoma, or uterine corpus cancer. The second one is sustained, but nevertheless low, excess risk - prostate cancer-specific mortality rate increased gradually and almost linearly from 5.3% to 15.1% after diagnosis from 5 to 30 years, and for breast cancer, it increased likewise from 7.2% to 18.9% after diagnosis from 5 to 40 years. Conclusions: Except for lung and ovarian cancers, patients diagnosed with major cancers were more likely to die from causes other than cancer. Colorectal, bladder, melanoma or uterine corpus cancer patients surviving more than 10 years after diagnosis are unlikely to ever die from that disease. [Table: see text]

Prediction of short- and long-term survival for advanced cancer patients after ICU admission

2014 ◽  
Vol 23 (6) ◽  
pp. 1647-1655 ◽  
Author(s):  
Su Jin Heo ◽  
Gyuri Kim ◽  
Choong-kun Lee ◽  
Kyung Soo Chung ◽  
Hye Jin Choi ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Icu Admission ◽  
Short And Long Term

International Subarachnoid Aneurysm Trial 2009

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 961-962 ◽  
Author(s):  
Nicolaas A. Bakker ◽  
Jan D.M. Metzemaekers ◽  
Rob J.M. Groen ◽  
Jan Jakob A. Mooij ◽  
J. Marc C. Van Dijk
Keyword(s):  
Mortality Rates ◽  
Everyday Clinical Practice ◽  
Combining Data ◽  
Significant Difference ◽  
International Subarachnoid Aneurysm Trial ◽  
Intent To Treat ◽  
Ruptured Intracranial Aneurysms ◽  
Treat Analysis

Abstract In the May 2009 issue of The Lancet Neurology, the 5-year follow-up results of the International Subarachnoid Aneurysm Trial (ISAT) were published. The authors concluded that, although the significant difference between coiling and neurosurgical clipping of ruptured intracranial aneurysms in terms of death and severe disability after 1 year has vanished (primary endpoint), coiling should still be favored over neurosurgical clipping because mortality rates significantly favored coiling. In this commentary, it is this particular conclusion that is challenged by combining data from previous ISAT publications with the current 5-year follow-up results. This modified intent-to-treat analysis clearly demonstrates that the significant advantage in terms of mortality in favor of the endovascularly treated patients is no longer present, with a hazard ratio of 0.80 in favor of endovascular treatment (95% confidence interval: 0.60–1.05; P = .10). Therefore, for everyday clinical practice and decision making, coiling and clipping are to be considered equivalent in the long term.

scholarly journals Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15–39 Years): A Population-Based Study in The Netherlands 1990–2016

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3421
Author(s):  
Daniël J. van der Meer ◽  
Henrike E. Karim-Kos ◽  
Marianne van der Mark ◽  
Katja K. H. Aben ◽  
Rhodé M. Bijlsma ◽  
...  
Keyword(s):  
The Netherlands ◽  
Cancer Patients ◽  
Cancer Incidence ◽  
Relative Survival ◽  
Mortality Rates ◽  
Adolescent And Young Adult ◽  
Mortality Trends ◽  
Netherlands Cancer Registry ◽  
Incidence And Mortality ◽  
Cancer Types

Adolescent and young adult (AYA) cancer patients, aged 15–39 years at primary cancer diagnosis, form a distinct, understudied, and underserved group in cancer care. This study aimed to assess long-term trends in incidence, survival, and mortality of AYA cancer patients within the Netherlands. Data on all malignant AYA tumours diagnosed between 1990–2016 (n = 95,228) were obtained from the Netherlands Cancer Registry. European age-standardised incidence and mortality rates with average annual percentage change (AAPC) statistics and five-year relative survival rates were calculated. The overall cancer incidence increased from 54.6 to 70.3 per 100,000 person-years (AAPC: +1.37%) between 1990–2016, and increased for both sexes individually and for most cancer types. Five-year relative survival overall improved from 73.7% in 1990–1999 to 86.4% in 2010–2016 and improved for both sexes and most cancer types. Survival remained poor (<60%) for rhabdomyosarcoma, lung, stomach, liver, bladder, and pancreatic carcinomas, among others. Mortality rates among male AYAs overall declined from 10.8 to 6.6 (AAPC: −1.64%) and from 14.4 to 10.1 per 100,000 person-years (AAPC: −1.81%) for female AYAs since 1990. Mortality rates remained unchanged for male AYAs aged 20–24 and 25–29 years. In conclusion, over the past three decades, there has been a considerable increase in cancer incidence among AYAs in the Netherlands. Meanwhile, the survival improved and the mortality overall declined. Survival at five-years now well exceeds above 80%, but did not do so for all cancer types.

Diabetes mellitus and survival of esophageal cancer patients after esophagectomy: a systematic review and meta-analysis

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Xi Zheng ◽  
Xingsheng Ma ◽  
Han-Yu Deng ◽  
Panpan Zha ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Outcome Data ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
The Impact

SUMMARY Diabetes mellitus (DM) is one of the most common comorbidities in esophageal cancer patients who undergo esophagectomy. It is well established that DM has an unfavorable impact on short-term outcomes of patients with surgically treated esophageal cancer; however, whether DM has any impact on long-term survival of these patients remains unclear. We performed the first meta-analysis to investigate the impact of DM on survival of surgically treated esophageal cancer patients. We searched the following databases systematically to retrieve relevant studies on January 2, 2019: PubMed, Embase, and Web of Science. The main outcome data consisting of 3- and 5-year overall survival (OS) rates and hazard ratios (HRs) of OS were extracted to compare survival between patients with and without DM. We finally included for meta-analysis a total of eight cohort studies involving 5,044 esophageal cancer patients who underwent esophagectomy. We found no significant difference between 3-year (risk ratio [RR] = 0.94, 95% CI: 0.73–1.21; P = 0.65) and 5-year (RR = 0.92, 95% CI: 0.80–1.08; P = 0.31) OS rates between patients with and without DM after esophagectomy. Moreover, DM was not found to be an independent predictor of OS for these patients (HR = 1.10, 95% CI: 0.65–1.84; P = 0.72). Our study suggests that DM appears to have no significant impact on long-term survival of esophageal cancer patients who undergo esophagectomy. To improve the prognosis of these patients, it may be more important to control glycemic level in patients with DM who undergo esophagectomy. However, further high-quality studies with appropriate adjustment for confounding factors are needed to verify this conclusion.

Remnant pancreatic volume to predict short-term and long-term outcomes in patients with resected pancreatic cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15713-e15713
Author(s):  
Ryoichi Miyamoto ◽  
Yukio Oshiro ◽  
Nobuhiro Ohkohchi
Keyword(s):  
Pancreatic Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Short Term ◽  
Significant Difference ◽  
Pancreatic Volume

e15713 Background: Remnant pancreatic volume (RPV) is a well-known marker for short-term outcomes in patients with resectable pancreatic cancer. However, in terms of the long-term outcomes, the significance of the RPV remains unclear. Here, we addressed whether the RPV is a predictor of long-term outcomes in pancreatic cancer patients by comparing various cancer-, patient-, and surgery-related prognostic factors and systemic inflammatory response markers in a retrospective cohort. Methods: The RPV was measured on the 3D image, revealing the actual pancreatic parenchymal remnant volume. Ninety-one patients who underwent pancreaticoduodenectomy (PD) were retrospectively enrolled. We divided the cohort into high- and low-RPV groups based on a cut-off value ( > 35.5 cm3, n = 66 and ≤ 35.5 cm3, n = 25, respectively). The patient characteristics, perioperative outcomes and median survival times (MSTs) were respectively compared between the two groups. Using multivariate analysis, the RPV and other well-known prognostic factors were independently assessed. Results: A significant difference in the RPV value was observed with respect to the incidence of postoperative pancreatic fistula (high, 18 [55%] vs. low, 9 [16%], p < 0.001). The MSTs (days) were significantly different between the two groups (high, 823 vs. low, 482, p = 0.001). Multivariate analysis identified the RPV (≤ 31.5 cm3) (hazard ratio [HR], 2.015; p = 0.011), lymph node metastasis (HR, 8.415; p = 0.002), adjuvant chemotherapy (HR, 5.352; p < 0.001), presence of stage III/IV disease (HR, 2.352; p = 0.029), and pathological fibrosis (HR, 1.771; p = 0.031) as independent prognostic factors. Conclusions: The present study suggests that the RPV is an additional useful predictor of both long-term and short-term outcomes in pancreatic cancer patients after PD.

Retinoblastoma in Finland, 1964–2014: incidence and survival

2020 ◽  
Vol 105 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Kalle Nummi ◽  
Tero T Kivelä
Keyword(s):  
Birth Cohort ◽  
Cohort Analysis ◽  
Mortality Rates ◽  
Second Malignancies ◽  
Male Preponderance ◽  
Observational Cohort ◽  
Improvement In Survival ◽  
Retrospective Observational Cohort Study ◽  
Birth Cohort Analysis

AimsTo determine the incidence of retinoblastoma (Rb) and subsequent survival in the Finnish population during five decades.MethodsThis retrospective observational cohort study comprised all patients with Rb born in Finland during 1964–2014 and diagnosed in 2018 (birth cohort analysis) or diagnosed in 1964–2014 (standard annual analysis), identified from the Finnish Cancer Registry and the national referral centre. We report age-adjusted incidences and survival according to cause of death.ResultsOf children born in 1964–2014, 205 developed Rb, whereas 204 Rbs were diagnosed during these years; 196 belonged to both cohorts. Altogether 80 (38%) of the 213 children had heritable Rb and 19 (9%) had familial disease. The sex ratio was 1.34, suggesting male preponderance. Birth cohort analysis showed a median incidence of 6.2 per 100 000 live births (1:16 130) and less variability as compared with standard annual analysis (12.1, 6.5 and 4.4 per million children 0–4, 0–9 and 0–14 years of age, respectively). The incidence of heritable Rb increased with time, reflecting the increase in familial tumours. Five-year mortality rates from Rb were 6.2% and 7.6% for non-heritable and heritable diseases, respectively, and 35-year mortality rates from second malignancies were 0% and 14.3%, respectively. Family history predicted improved survival, whereas the period of diagnosis did not.ConclusionThe incidence of familial Rb has increased, along with improvement in survival in Finland in 1964–2014, whereas the overall incidence of Rb was stable. Long-term risk of dying of second malignancies after heritable Rb was in line with other countries.

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