Sarcoma Patients Admitted to the Intensive Care Unit (ICU): Predictive Relevance of Common Sepsis and Performance Parameters

Jana K Striefler; Phung T Binder; Franziska Brandes; Daniel Rau; Silvan Wittenberg; David Kaul; Siyer Roohani; Armin Jarosch; Frederik M Schäfer; Robert Öllinger; Sven Märdian; Lars Bullinger; Kai-Uwe Eckardt; Jan Kruse; Anne Flörcken

doi:10.2147/CMAR.S400430

Sarcoma Patients Admitted to the Intensive Care Unit (ICU): Predictive Relevance of Common Sepsis and Performance Parameters

Cancer Manag Res. 2023 Mar 27:15:321-334. doi: 10.2147/CMAR.S400430. eCollection 2023.

Authors

Jana K Striefler^{1

2}, Phung T Binder², Franziska Brandes², Daniel Rau³, Silvan Wittenberg³, David Kaul⁴, Siyer Roohani⁴, Armin Jarosch⁵, Frederik M Schäfer⁶, Robert Öllinger⁷, Sven Märdian³, Lars Bullinger^{2

8}, Kai-Uwe Eckardt⁹, Jan Kruse⁹, Anne Flörcken^{2

8}

Affiliations

¹ Department of Internal Medicine II, Oncology/Hematology/BMT/Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Centre for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Department of Radiation Oncology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁵ Institute of Pathology, Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁶ Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
⁷ Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁸ German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany.
⁹ Department of Nephrology and Medical Intensive Care, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Abstract

Purpose: Prognosis of sarcoma patients is improving, with a better understanding of sarcomagenesis revealing novel therapeutic targets. However, aggressive chemotherapy remains an essential part of treatment, bearing the risk of severe side effects that require intensive medical treatment. Available data on the characteristics and clinical outcome of sarcoma patients admitted to intensive care units (ICU) are sparse.

Patients and methods: We performed a retrospective analysis of sarcoma patients admitted to the ICU from 2005 to 2022. Patients ≥18 years with histologically proven sarcoma were included in our study.

Results: Sixty-six patients were eligible for analysis. The following characteristics had significant impact on overall survival: sex (p=0.046), tumour localization (p=0.02), therapeutic intention (p=0.02), line of chemotherapy (p<0.001), SAPS II score (p=0.03) and SOFA score (p=0.02).

Conclusion: Our study confirms the predictive relevance of established sepsis and performance scores in sarcoma patients. For overall survival, common clinical characteristics are also of significant value. Further investigation is needed to optimize ICU treatment of sarcoma patients.

Keywords: ICU-specific survival; SAPS II; SOFA; intensive care unit; sepsis and performance scores; soft tissue sarcoma.