Clinical Outcomes of Thoracic Cancer Patients Requiring ICU Admission: A 10-Year Retrospective Study

Introduction Lung cancer is the most common solid malignancy requiring intensive care unit (ICU) admission, but ICU admission for cancer patients is often denied, being the second most common reason for refusal. This study aimed to evaluate the outcomes of thoracic cancer patients admitted to the ICU and understand the characteristics that may affect these outcomes. Methods This retrospective cohort study analyzed 25 patients with lung cancer admitted to the ICU between 2014 and 2023 at the Multidisciplinary Thoracic Tumors Unit of a tertiary hospital in Portugal. Clinical characteristics and survival outcomes were assessed. Results Patients had a median age of 68 years, were predominantly male (72%), and mostly had stage IV disease (76%). Over 10 years, ICU admissions for thoracic cancer patients increased, with septic shock being the primary reason for admission. Respiratory and cardiovascular dysfunctions were prevalent, requiring frequent respiratory support. Mortality rates were 60% at 28 days, 72% at 6 months, and 76% at 12 months. Higher SOFA and SAPS II scores, hematological dysfunction, and invasive mechanical ventilation were associated with higher 28-day mortality. Conclusion ICU mortality was linked to severity at admission, not oncological disease burden. Survivors maintained functional status and continued treatment. Advancements in lung cancer therapies and rising survival rates emphasize the need to update ICU admission criteria and mortality predictor scores.