University of Hertfordshire

Intensive care in patients with lung cancer: a multinational study

Research output: Contribution to journalArticle


  • M Soares
  • A-C Toffart
  • J-F Timsit
  • G Burghi
  • C Irrazábal
  • N Pattison
  • E Tobar
  • B F C Almeida
  • U V A Silva
  • L C P Azevedo
  • A Rabbat
  • C Lamer
  • A Parrot
  • V C Souza-Dantas
  • F Wallet
  • F Blot
  • G Bourdin
  • C Piras
  • J Delemazure
  • M Durand
  • D Tejera
  • J I F Salluh
  • E Azoulay
  • Lung Cancer in Critical Care (LUCCA) Study Investigators
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Original languageEnglish
Pages (from-to)1829-35
Number of pages7
JournalAnnals of Oncology
Early online date20 Jun 2014
Publication statusPublished - 1 Sep 2014


BACKGROUND: Detailed information about lung cancer patients requiring admission to intensive care units (ICUs) is mostly restricted to single-center studies. Our aim was to evaluate the clinical characteristics and outcomes of lung cancer patients admitted to ICUs.

PATIENTS AND METHODS: Prospective multicenter study in 449 patients with lung cancer (small cell, n = 55; non-small cell, n = 394) admitted to 22 ICUs in six countries in Europe and South America during 2011. Multivariate Cox proportional hazards frailty models were built to identify characteristics associated with 30-day and 6-month mortality.

RESULTS: Most of the patients (71%) had newly diagnosed cancer. Cancer-related complications occurred in 56% of patients; the most common was tumoral airway involvement (26%). Ventilatory support was required in 53% of patients. Overall hospital, 30-day, and 6-month mortality rates were 39%, 41%, and 55%, respectively. After adjustment for type of admission and early treatment-limitation decisions, determinants of mortality were organ dysfunction severity, poor performance status (PS), recurrent/progressive cancer, and cancer-related complications. Mortality rates were far lower in the patient subset with nonrecurrent/progressive cancer and a good PS, even those with sepsis, multiple organ dysfunctions, and need for ventilatory support. Mortality was also lower in high-volume centers. Poor PS predicted failure to receive the initially planned cancer treatment after hospital discharge.

CONCLUSIONS: ICU admission was associated with meaningful survival in lung cancer patients with good PS and non-recurrent/progressive disease. Conversely, mortality rates were very high in patients not fit for anticancer treatment and poor PS. In this subgroup, palliative care may be the best option.


This is a pre-copyedited, author-produced version of an article accepted for publication in Annals of Oncology following peer review. The version of record M. Soares, et al, 'Intensive care in patients with lung cancer: a multinational study', Annals of Oncology, Vol. 25 (9): 1829-1835, September 2014, is available online at

ID: 12903525