The prognosis of cancer patients admitted to ICU for a medical problem is first determined by the acute physiologic changes induced by the complication, as evaluated by the severity scores. There is no major difference between the two assessed scoring systems. They are, however, not accurate enough to be used in the routine management of these patients. After recovery from complications, characteristics related to the neoplastic disease, however, retrieve their independent influence on the further survival.

The present systematic review was performed under the auspices of the European Lung Cancer Working Party (ELCWP) in order to determine the role of early intermediate criteria (surrogate markers), instead of survival, in determining treatment efficacy in patients with lung cancer. Initially, the level of evidence for the use of overall survival to evaluate treatment efficacy was reviewed. Nine questions were then formulated by the ELCWP. After reviewing the literature with experts on these questions, it can be concluded that overall survival is still the best criterion for predicting treatment efficacy in lung cancer. Some intermediate criteria can be early predictors, if not surrogates, for survival, despite limitations in their potential application: these include time to progression, progression-free survival, objective response, local control after radiotherapy, downstaging in locally advanced nonsmall cell lung cancer (NSCLC), complete resection and pathological TNM in resected NSCLC, and a few circulating markers. Other criteria assessed in these recommendations are not currently adequate surrogates of survival in lung cancer.

NIV appears to be an effective ventilation support for cancer patients with "life-support techniques limitation".

This study aimed to determine the effectiveness and potential indications of cardiopulmonary resuscitation (CPR) in medical cancer patients, by retrospective analysis of the records of the patients admitted between November 1985 and January 1992 in the medical intensive-care unit of a cancer hospital following cardiac arrest. Cardiac arrest occurred in 49 cancer patients. CPR was successful in 19 (39%) but only 5 (10%) were discharged alive from the hospital. CPR was successful in all 8 patients in which cardiac arrest was the consequence of an acute cardiovascular drug toxicity, even if the cancer was metastatic and the purpose of treatment not curative, while it was effective in only 25% of those where cardiac arrest was an ultimate complication of various problems such as septic shock or respiratory failure complicating the neoplastic disease. The results suggest that in cancer, as in other types of disease, CPR is mainly indicated when cardiac arrest is the consequence of an acute insult.