Outcome of Critically Ill Patients with Testicular Cancer

Abstract

Purpose To evaluate the clinical characteristics and outcomes of critically ill patients with testicular cancer (TC) admitted to an oncological intensive care unit (ICU). Methods This was a prospective observational study. There were no interventions. Results During the study period, 1,402 patients with TC were admitted to the Department of Oncology, and 60 patients (4.3%) were admitted to the ICU. The most common histologic type was nonseminomatous germ cell tumors (55/91.7%). The ICU, hospital, and 6-month mortality rates were 38.3%, 45%, and 63.3%, respectively. The Cox multivariate analysis identified the white blood cells count (HR = 1.06, 95% CI = 1.01–1.11, and P = 0.005), ionized calcium (iCa) level (HR = 1.23, 95% CI = 1.01–1.50, and P = 0.037), and 2 or more organ failures during the first 24 hours after ICU admission (HR = 3.86, 95% CI = 1.96–7.59, and P < 0.001) as independent predictors of death for up to 6 months. Conclusion The ICU, hospital, and 6-month mortality rates were 38.3%, 45%, and 63.3%, respectively. The factors associated with an increased 6-month mortality rate were white blood cells count, iCa level, and 2 or more organ failures during the first 24 hours after ICU admission.

A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs

“…The characteristics of the 46 included studies are described in eTable 1 (http://links.lww.com/CCX/B54). Most of the published literature was from Europe ( n = 18) (15–32), followed by Asia ( n = 12) (33–44), North America ( n = 9) (4, 45–52), South America ( n = 5) (5, 53–56), and Oceania ( n = 2) (57, 58). On the other hand, studies from North America contributed the highest number of patients ( n = 37,255), followed by South America ( n = 32,723), Asia ( n = 23,540), Europe ( n = 16,149), and Oceania ( n = 478).…”

“…Supplementary Figures 4 and 5 (http://links.lww.com/CCX/B54) show the pooled hospital mortality rates for patients with hematologic and solid malignancies. Seven studies reported data enabling direct comparison of these subgroups (4, 14, 21, 26, 42, 50, 55). Patients with hematologic malignancies were 43% more likely to die in the hospital than were patients with solid malignancies (RR, 1.43; 95% CI, 1.13–1.81; I 2 = 96.3%) ( Supplementary Fig.…”

A 12-year study evaluating the outcomes and predictors of mortality in critically ill cancer patients admitted with septic shock

“…In our study, the presence of elevated total bilirubin level was associated with both ICU and hospital mortality. Ñamendys-Silva et al [ 14 ] also reported that total bilirubin level is one of the predictors for organ failure that is associated with ICU mortality. On the other hand, Regazzoni et al [ 19 ] did not find a significant association between liver dysfunction and mortality.…”

Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study

“…17 Patients may present with a testicular mass and can develop additional symptoms from growing metastatic lesions, but the prognosis is generally good — with 5-year survival rates of 97% — because most cases are caught early. 17 – 20 …”

“… 18 , 19 Patients with TGCTs are nearly always seen and treated by an oncologist, because cure and long-term survival are possible, even if they are more challenging with advanced presentations. 19 , 20 Based on their histology, TGCTs are classified as seminomas or nonseminomas and given a stage of I to III. Stage I disease typically requires orchiectomy alone; stage II disease requires further surgery, radiation (for seminomas) or systemic therapy (for lymph nodes); and stage III disease requires systemic therapy for metastatic disease.…”