Retrospective study of 100-day mortality in advanced solid malignancies: Real world experience in a tertiary cancer center from South India

Background: Mortality rate serves as the clinical indicator of the quality of care and appropriateness of clinical decisions. However, Indian data on 100-day mortality in patients with Stage IV disease, post-palliative therapy is lacking. Objectives: The primary objective was to assess 100-day mortality in patients receiving palliative systemic therapy for advanced solid tumors. The secondary objective was to identify associated predictive factors. Materials and Methods: This retrospective cohort study included adults (>18 years) with Stage IV solid malignancies, who were planned for palliative systemic therapy at the Medical Oncology department, from a tertiary cancer center in South India over a 6-month period. Data were retrieved from electronic medical records. Mortality within 100-day was confirmed through records and telephonic interviews. Analysis was performed using Statistical package for the Social Sciences (SPSS) Version 25, (IBM Corp.), with P < 0.050 considered significant. Results: We included 144 patients in the study. The median age was 53 years (IQR: 43-62), with 19.4% ( n = 28) aged >65 years. Males and females were equally represented. Gastrointestinal and biliary cancers were most common (35.4%, n = 51). Metastatic disease was present in 88.2% ( n = 127) of cases, of which 11.8% ( n = 15) were oligometastatic. The 100-day mortality rate was 16% ( n = 23). Subgroup analysis showed that neutrophil-lymphocyte ratio ( P , 0.040) and performance status ( P , 0.020) significantly influenced mortality. Conclusion: In the era of advanced therapeutics, evaluating 100-day mortality provides insight into clinical decision-making for Stage IV patients. Neutrophil-lymphocyte ratio and performance status are key prognostic indicators.